Does increased water intake prevent disease progression in autosomal dominant polycystic kidney disease?

Nephrol Dial Transplant. 2014 Sep;29(9):1710-9. doi: 10.1093/ndt/gfu093. Epub 2014 Apr 15.


Background: The clinical effects of increased water intake on autosomal dominant polycystic kidney disease (ADPKD) progression are unknown.

Methods: ADPKD patients with creatinine clearance ≧ 50 mL/min/1.73 m(2) were divided into high (H-, n = 18) and free (F-, n = 16) water-intake groups, mainly according to their preference. Prior to the study, 30 patients underwent annual evaluation of total kidney volume (TKV) and 24-h urine for an average of 33 months. During the 1-year study period, TKV and 24-h urine were analyzed at the beginning and end of the study and every 4 months, respectively.

Results: During the pre-study period, urine volume (UV) in the H-group was higher (P = 0.034), but TKV and kidney function and their slopes were not significantly different between the two groups. After the study commenced, UV further increased (P < 0.001) in the H-group but not in the F-group. During the study period, TKV and kidney function slopes were not significantly different between the two groups (primary endpoint). Plasma copeptin was lower (P = 0.024) in the H-group than in the F-group. TKV and kidney function slopes became worse (P = 0.047 and 0.011, respectively) after high water intake (H-group) but not in the F-group. High UV was associated with increased urine sodium, and urine sodium positively correlated with the % TKV slope (P = 0.014).

Conclusions: Although the main endpoint was not significant, high water intake enhanced disease progression in the H-group when compared with the pre-study period. These findings necessitate a long-term randomized study before drawing a final conclusion.

Keywords: autosomal dominant polycystic kidney disease; glomerular filtration rate; kidney volume; urine volume; vasopressin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Blood Pressure
  • Disease Progression
  • Drinking*
  • Female
  • Glomerular Filtration Rate
  • Glycopeptides / blood*
  • Humans
  • Kidney / pathology
  • Kidney / physiopathology
  • Male
  • Middle Aged
  • Organ Size
  • Polycystic Kidney, Autosomal Dominant / blood
  • Polycystic Kidney, Autosomal Dominant / pathology*
  • Polycystic Kidney, Autosomal Dominant / physiopathology
  • Young Adult


  • Glycopeptides
  • copeptins