Urine Volume and Change in Estimated GFR in a Community-Based Cohort Study
Urine Volume and Change in Estimated GFR in a Community-Based Cohort Study
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DOI：
10.2215/cjn.01990211
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发表时间：
2011-11-01
影响因子：
9.8
通讯作者：
Garg, Amit X.
中科院分区：
文献类型：
--
作者：
Clark, William F.;Sontrop, Jessica M.;Garg, Amit X.
背景和目的液体摄入量增加对肾功能的影响尚不清楚。这项研究评估了尿量和肾功能下降之间的关系超过6年在一个大型的社区为基础的coherent.Design，设置，参与者和测量这项前瞻性队列研究是在加拿大进行的2002年至2008年。我们从成人受试者中获得了24小时尿液样本，这些受试者在进入研究时的估计GFR（eGFR）>= 60 ml/min/1.73 m2。结果2148名参与者提供了有效的24小时尿液样本，分组为= 3 L/d（7.7%）。每类尿量的基线eGFR分别为90、88、84和87 ml/min/1.73 m2。总体而言，eGFR每年下降1%，其中10%表现出快速下降，40%表现出轻度至中度下降。尿量和eGFR下降之间存在明显的反向分级关系：对于24小时尿量的每个增加类别，eGFR年下降百分比逐渐变慢，分别从1.3%、1.0%、0.8%至0.5%; P = 0.02。与尿量为1至1.9 Lid的患者相比，尿量>= 3 L/d的患者出现轻度至中度下降的可能性显著降低（调整后的比值比0.66; 95%置信区间0.46至0.94）或快速下降（校正比值比0.46; 95%置信区间0.23 - 0.92）;根据年龄、性别、基线eGFR、高血压药物使用进行校正结论：在这个以社区为基础的队列中，尿量高的患者肾功能下降明显慢于尿量低的患者。Clin J Am Soc Nephrol 6：2634-2641，2011. doi：10.2215/CJN.01990211
Background and objectives The effect of increased fluid intake on kidney function is unclear. This study evaluates the relationship between urine volume and renal decline over 6 years in a large community-based cohort.Design, setting, participants, & measurements This prospective cohort study was undertaken in Canada from 2002 to 2008. We obtained 24-hour urine samples from adult participants with an estimated GFR (eGFR) >= 60ml/min per 1.73 m(2) at study entry. Percentage annual change in eGFR from baseline was categorized as average decline = 5% (rapid decline).Results 2148 participants provided valid 24-hour urine samples, grouped as = 3 L/d (7.7%). Baseline eGFR for each category of urine volume was 90, 88, 84, and 87 ml/min per 1.73 m2, respectively. Overall, eGFR declined by 1% per year, with 10% demonstrating rapid decline and 40% demonstrating mild-to-moderate decline. An inverse, graded relationship was evident between urine volume and eGFR decline: For each increasing category of 24-hour urine volume, percentage annual eGFR decline was progressively slower, from 1.3%, 1.0%, 0.8%, to 0.5%, respectively; P = 0.02. Compared with those with urine volume 1 to 1.9 Lid, those with urine volume >= 3 L/d were significantly less likely to demonstrate mild-to-moderate decline (adjusted odds ratio 0.66; 95% confidence interval 0.46 to 0.94) or rapid decline (adjusted odds ratio 0.46; 95% confidence interval 0.23 to 0.92); adjusted for age, gender, baseline eGFR, medication use for hypertension (including diuretics), proteinuria, diabetes, and cardiovascular disease.Conclusions In this community-based cohort, decline in kidney function was significantly slower in those with higher versus lower urine volume. Clin J Am Soc Nephrol 6: 2634-2641, 2011. doi: 10.2215/CJN.01990211