PubTransformer

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PMID- 29801012
OWN - NLM
STAT- MEDLINE
DCOM- 20180607
LR  - 20180607
IS  - 1538-3598 (Electronic)
IS  - 0098-7484 (Linking)
VI  - 319
IP  - 18
DP  - 2018 May 8
TI  - Effect of Coaching to Increase Water Intake on Kidney Function Decline in Adults 
      With Chronic Kidney Disease: The CKD WIT Randomized Clinical Trial.
PG  - 1870-1879
LID - 10.1001/jama.2018.4930 [doi]
AB  - Importance: In observational studies, increased water intake is associated with
      better kidney function. Objective: To determine the effect of coaching to
      increase water intake on kidney function in adults with chronic kidney disease.
      Design, Setting, and Participants: The CKD WIT (Chronic Kidney Disease Water
      Intake Trial) randomized clinical trial was conducted in 9 centers in Ontario,
      Canada, from 2013 until 2017 (last day of follow-up, May 25, 2017). Patients had 
      stage 3 chronic kidney disease (estimated glomerular filtration rate [eGFR] 30-60
      mL/min/1.73 m2 and microalbuminuria or macroalbuminuria) and a 24-hour urine
      volume of less than 3.0 L. Interventions: Patients in the hydration group (n =
      316) were coached to drink more water, and those in the control group (n = 315)
      were coached to maintain usual intake. Main Outcomes and Measures: The primary
      outcome was change in kidney function (eGFR from baseline to 12 months).
      Secondary outcomes included 1-year change in plasma copeptin concentration,
      creatinine clearance, 24-hour urine albumin, and patient-reported overall quality
      of health (0 [worst possible] to 10 [best possible]). Results: Of 631 randomized 
      patients (mean age, 65.0 years; men, 63.4%; mean eGFR, 43 mL/min/1.73 m2; median 
      urine albumin, 123 mg/d), 12 died (hydration group [n = 5]; control group [n =
      7]). Among 590 survivors with 1-year follow-up measurements (95% of 619), the
      mean change in 24-hour urine volume was 0.6 L per day higher in the hydration
      group (95% CI, 0.5 to 0.7; P < .001). The mean change in eGFR was -2.2
      mL/min/1.73 m2 in the hydration group and -1.9 mL/min/1.73 m2 in the control
      group (adjusted between-group difference, -0.3 mL/min/1.73 m2 [95% CI, -1.8 to
      1.2; P = .74]). The mean between-group differences (hydration vs control) in
      secondary outcomes were as follows: plasma copeptin, -2.2 pmol/L (95% CI, -3.9 to
      -0.5; P = .01); creatinine clearance, 3.6 mL/min/1.73 m2 (95% CI, 0.8 to 6.4; P =
      .01); urine albumin, 7 mg per day (95% CI, -4 to 51; P = .11); and quality of
      health, 0.2 points (95% CI, -0.3 to 0.3; P = .22). Conclusions and Relevance:
      Among adults with chronic kidney disease, coaching to increase water intake
      compared with coaching to maintain the same water intake did not significantly
      slow the decline in kidney function after 1 year. However, the study may have
      been underpowered to detect a clinically important difference. Trial
      Registration: clinicaltrials.gov Identifier: NCT01766687.
FAU - Clark, William F
AU  - Clark WF
AD  - London Health Sciences Centre, London, Ontario, Canada.
AD  - Department of Medicine, Western University, London, Ontario, Canada.
FAU - Sontrop, Jessica M
AU  - Sontrop JM
AD  - London Health Sciences Centre, London, Ontario, Canada.
AD  - Department of Epidemiology and Biostatistics, Western University, London,
      Ontario, Canada.
FAU - Huang, Shih-Han
AU  - Huang SH
AD  - London Health Sciences Centre, London, Ontario, Canada.
AD  - Department of Medicine, Western University, London, Ontario, Canada.
FAU - Gallo, Kerri
AU  - Gallo K
AD  - London Health Sciences Centre, London, Ontario, Canada.
FAU - Moist, Louise
AU  - Moist L
AD  - London Health Sciences Centre, London, Ontario, Canada.
AD  - Department of Medicine, Western University, London, Ontario, Canada.
AD  - Department of Epidemiology and Biostatistics, Western University, London,
      Ontario, Canada.
FAU - House, Andrew A
AU  - House AA
AD  - London Health Sciences Centre, London, Ontario, Canada.
AD  - Department of Medicine, Western University, London, Ontario, Canada.
FAU - Cuerden, Meaghan S
AU  - Cuerden MS
AD  - London Health Sciences Centre, London, Ontario, Canada.
FAU - Weir, Matthew A
AU  - Weir MA
AD  - London Health Sciences Centre, London, Ontario, Canada.
AD  - Department of Medicine, Western University, London, Ontario, Canada.
FAU - Bagga, Amit
AU  - Bagga A
AD  - Department of Medicine, Western University, London, Ontario, Canada.
AD  - Hotel-Dieu Grace Hospital, Windsor, Ontario, Canada.
FAU - Brimble, Scott
AU  - Brimble S
AD  - Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
FAU - Burke, Andrew
AU  - Burke A
AD  - Guelph General Hospital, Guelph, Ontario, Canada.
FAU - Muirhead, Norman
AU  - Muirhead N
AD  - London Health Sciences Centre, London, Ontario, Canada.
AD  - Department of Medicine, Western University, London, Ontario, Canada.
FAU - Pandeya, Sanjay
AU  - Pandeya S
AD  - Halton Healthcare Services, Oakville, Ontario, Canada.
FAU - Garg, Amit X
AU  - Garg AX
AD  - London Health Sciences Centre, London, Ontario, Canada.
AD  - Department of Medicine, Western University, London, Ontario, Canada.
AD  - Department of Epidemiology and Biostatistics, Western University, London,
      Ontario, Canada.
LA  - eng
SI  - ClinicalTrials.gov/NCT01766687
GR  - CIHR/Canada
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - JAMA
JT  - JAMA
JID - 7501160
RN  - 059QF0KO0R (Water)
SB  - AIM
SB  - IM
MH  - Aged
MH  - Disease Progression
MH  - *Drinking
MH  - Female
MH  - Glomerular Filtration Rate
MH  - Health Behavior
MH  - Humans
MH  - Male
MH  - *Mentoring
MH  - Middle Aged
MH  - Osmolar Concentration
MH  - Patient Education as Topic
MH  - Renal Insufficiency, Chronic/physiopathology/*therapy/urine
MH  - Urine/chemistry
MH  - Water/*administration & dosage
EDAT- 2018/05/26 06:00
MHDA- 2018/06/08 06:00
CRDT- 2018/05/26 06:00
PHST- 2018/05/26 06:00 [entrez]
PHST- 2018/05/26 06:00 [pubmed]
PHST- 2018/06/08 06:00 [medline]
AID - 2680548 [pii]
AID - 10.1001/jama.2018.4930 [doi]
PST - ppublish
SO  - JAMA. 2018 May 8;319(18):1870-1879. doi: 10.1001/jama.2018.4930.