Fluid Intake for Kidney Disease Prevention: An Urban Myth?

[摘要] Any healthcare provider who works with patients afflicted with chronic kidney disease (CKD) has, at some point, discussed the importance of healthy kidneys and CKD prevention with patients' family members and friends. What should an expert recommend for the prevention of kidney disease? Certainly, early recognition and control of hypertension and diabetes, and avoidance of nephrotoxic agents, would be included in the conversation. One may also discuss the importance of maintaining a healthy weight through exercise and diet, given that the majority of kidney disease is due, at least in part, to nutritional factors. However, many individuals seeking advice for the prevention of kidney disease request specific guidelines for water intake and query on the amount of water intake needed to “flush” out toxins in the kidney. The “urban myth” of eight 8-ounce glasses of water (a half gallon or 1.9 L) per day to enhance health (1) appears to originate from the U.S. Food and Nutrition Board of the National Research Council in 1945, which recommended daily water intake of 2.5 L (2). These guidelines were based on opinion, not scientific evidence (3), and suggested the majority of the 2.5 L/d of water intake be derived from prepared foods (2). This portion of the 1945 recommendation has been largely ignored (3). In 2004, these recommendations were amended to account for the numerous individual and environmental factors that influence water requirements. The Food and Nutrition Board did not set exact guidelines for water intake but instead suggested general requirements at 2.7 L for women and 3.7 L for men, with fluid pertaining to all food and nonalcoholic beverages, including caffeinated drinks (4). While hydration has been suggested to provide multiple benefits in different aspects of health and well-being, including cognitive function, weight loss, and prevention of diseases, associations have not been supported by strong scientific evidence (3,5).

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome