Skip to main content

Advertisement

SpringerLink
Log in

Treatment effect, adherence, and safety of high fluid intake for the prevention of incident and recurrent kidney stones: a systematic review and meta-analysis

  • Original Article
  • Published:
Journal of Nephrology Aims and scope Submit manuscript

Abstract

Background

The objective of this systematic review and meta-analysis were to evaluate the effectiveness of high fluid intake for the prevention of incident and recurrent kidney stones, as well as its adherence and safety.

Methods

A literature search was performed encompassing 1980 through July 2014. Studies that reported relative risks, odds ratios, or hazard ratios comparing the risk of kidney stone events in patients with high vs inadequate fluid intake were included. Pooled risk ratios (RRs) and 95 % confidence intervals (CIs) were calculated using a random-effect, generic inverse variance method.

Results

Nine studies [2 randomized controlled trials (RCTs) with 269 patients; 7 observational studies with 273,685 individuals] were included in the meta-analysis. Pooled RRs of kidney stones in individuals with high-fluid intake were 0.40 (95 % CI 0.20–0.79) and 0.49 (0.34–0.71) in RCTs and observational studies, respectively. High fluid intake was significantly associated with reduced risk of recurrent kidney stones: RRs 0.40 (95 % CI 0.20–0.79) and 0.20 (0.09–0.44) in RCTs and observational studies, respectively. Adherence and safety data on high fluid intake treatment were limited; 1 RCT reported no withdrawals due to adverse events.

Conclusion

This analysis demonstrated a significantly reduced risk of incident kidney stones among individuals with high fluid consumption. High fluid consumption also reduced the risk of recurrent kidney stones. Furthermore, the magnitude of risk reduction was high. Although increased water intake appears to be safe, future studies on its safety in patients with high risk of volume overload or hyponatremia may be indicated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

AUA:

American Urological Association

ACP:

American College of Physicians

CI:

Confidence interval

RCT:

Randomized clinical trial

RR:

Risk ratio

References

  1. Goldfarb DS (2003) Increasing prevalence of kidney stones in the united states. Kidney Int 63:1951–1952

    Article  PubMed  Google Scholar 

  2. Long LO, Park S (2007) Update on nephrolithiasis management. Minerva Urol Nefrol 59:317–325

    CAS  PubMed  Google Scholar 

  3. Lopez M, Hoppe B (2010) History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol 25:49–59

    Article  PubMed  Google Scholar 

  4. Stamatelou KK, Francis ME, Jones CA, Nyberg LM, Curhan GC (2003) Time trends in reported prevalence of kidney stones in the united states: 1976–1994. Kidney Int 63:1817–1823

    Article  PubMed  Google Scholar 

  5. Qaseem A, Dallas P, Forciea MA, Starkey M, Denberg TD (2014) Dietary and pharmacologic management to prevent recurrent nephrolithiasis in adults: a clinical practice guideline from the american college of physicians. Ann Intern Med 161:659–667

    Article  PubMed  Google Scholar 

  6. Pearle MS, Goldfarb DS, Assimos DG, Curhan G, Denu-Ciocca CJ, Matlaga BR, Monga M, Penniston KL, Preminger GM, Turk TM, White JR (2014) Medical management of kidney stones: AUA guideline. J Urol 192:316–324

    Article  PubMed  Google Scholar 

  7. Wang CJ, Grantham JJ, Wetmore JB (2013) The medicinal use of water in renal disease. Kidney Int 84:45–53

    Article  PubMed  Google Scholar 

  8. Dawson CH, Tomson CR (2012) Kidney stone disease: pathophysiology, investigation and medical treatment. Clin Med 12:467–471

    Article  Google Scholar 

  9. Bao Y, Wei Q (2012) Water for preventing urinary stones. Cochrane Database Syst Rev 6:CD004292

    Google Scholar 

  10. Linder BJ, Rangel LJ, Krambeck AE (2013) The effect of work location on urolithiasis in health care professionals. Urolithiasis 41:327–331

    Article  PubMed  Google Scholar 

  11. Sarica K, Inal Y, Erturhan S, Yagci F (2006) The effect of calcium channel blockers on stone regrowth and recurrence after shock wave lithotripsy. Urol Res 34:184–189

    Article  CAS  PubMed  Google Scholar 

  12. Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A (1996) Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: a 5-year randomized prospective study. J Urol 155:839–843

    Article  CAS  PubMed  Google Scholar 

  13. Curhan GC, Willett WC, Rimm EB, Stampfer MJ (1997) Family history and risk of kidney stones. J Am Soc Nephrol 8:1568–1573

    CAS  PubMed  Google Scholar 

  14. Curhan GC, Willett WC, Speizer FE, Spiegelman D, Stampfer MJ (1997) Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. Ann Intern Med 126:497–504

    Article  CAS  PubMed  Google Scholar 

  15. Daudon M, Hennequin C, Boujelben G, Lacour B, Jungers P (2005) Serial crystalluria determination and the risk of recurrence in calcium stone formers. Kidney Int 67:1934–1943

    Article  PubMed  Google Scholar 

  16. Hosking DH, Erickson SB, Van den Berg CJ, Wilson DM, Smith LH (1983) The stone clinic effect in patients with idiopathic calcium urolithiasis. J Urol 130:1115–1118

    CAS  PubMed  Google Scholar 

  17. Taylor EN, Stampfer MJ, Curhan GC (2004) Dietary factors and the risk of incident kidney stones in men: new insights after 14 years of follow-up. J Am Soc Nephrol 15:3225–3232

    Article  PubMed  Google Scholar 

  18. Strauss AL, Coe FL, Deutsch L, Parks JH (1982) Factors that predict relapse of calcium nephrolithiasis during treatment: a prospective study. Am J Med 72:17–24

    Article  CAS  PubMed  Google Scholar 

  19. Embon OM, Rose GA, Rosenbaum T (1990) Chronic dehydration stone disease. Br J Urol 66:357–362

    Article  CAS  PubMed  Google Scholar 

  20. Jadad AR, Moore RA, Carroll D, Jenkinson C, Reynolds DJ, Gavaghan DJ, McQuay HJ (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12

    Article  CAS  PubMed  Google Scholar 

  21. Stang A (2010) Critical evaluation of the newcastle-ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605

    Article  PubMed  Google Scholar 

  22. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188

    Article  CAS  PubMed  Google Scholar 

  23. Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560

    Article  PubMed  PubMed Central  Google Scholar 

  24. Easterbrook PJ, Berlin JA, Gopalan R, Matthews DR (1991) Publication bias in clinical research. Lancet 337:867–872

    Article  CAS  PubMed  Google Scholar 

  25. Curhan GC, Willett WC, Knight EL, Stampfer MJ (2004) Dietary factors and the risk of incident kidney stones in younger women: nurses’ health study ii. Arch Intern Med 164:885–891

    Article  PubMed  Google Scholar 

  26. Buckley CM, Hawthorne A, Colyer A, Stevenson AE (2011) Effect of dietary water intake on urinary output, specific gravity and relative supersaturation for calcium oxalate and struvite in the cat. Br J Nutr 106(Suppl 1):S128–S130

    Article  CAS  PubMed  Google Scholar 

  27. Chung BD, Parekh U, Sellin JH (1999) Effect of increased fluid intake on stool output in normal healthy volunteers. J Clin Gastroenterol 28:29–32

    Article  CAS  PubMed  Google Scholar 

  28. Xu H, Zisman AL, Coe FL, Worcester EM (2013) Kidney stones: an update on current pharmacological management and future directions. Expert Opin Pharmacother 14:435–447

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Sawyer MD, Anderson CB, Viprakasit DP, Dietrich MS, Herrell SD, Miller NL (2013) An individualized weight-based goal urine volume model significantly improves expected calcium concentrations relative to a 2-l goal urine volume. Urolithiasis 41:403–409

    Article  CAS  PubMed  Google Scholar 

  30. Hariprasad MK, Eisinger RP, Nadler IM, Padmanabhan CS, Nidus BD (1980) Hyponatremia in psychogenic polydipsia. Arch Intern Med 140:1639–1642

    Article  CAS  PubMed  Google Scholar 

  31. Kawai N, Baba A, Suzuki T, Shiraishi H (2001) Roles of arginine vasopressin and atrial natriuretic peptide in polydipsia-hyponatremia of schizophrenic patients. Psychiatry Res 101:39–45

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

Research work for this review was supported by Otsuka America Pharmaceutical, Inc. Editorial assistance was provided by Catherine Fontana and Geoff Marx of BioScience Communications (New York, NY), which was funded by Otsuka. The investigators also acknowledge support from the Rare Kidney Stone Consortium (U54KD083908), a member of the NIH Rare Diseases Clinical Research Network (RDCRN), funded by the NIDDK and the National Center for Advancing Translational Sciences (NCATS), and the Mayo Clinic O’Brien Urology Research Center (U54 DK100227).

Conflict of interest

Wisit Cheungpasitporn, Stephen B. Erickson have nothing to disclose. Sandro Rossetti and Keith Friend are employees of Otsuka America Pharmaceutical, Inc. John C. Lieske Supported by the Mayo Clinic O’Brien Urology Research Center and Rare Kidney Stone Consortium, member of the National Institutes of Health Rare Diseases Clinical Research Network, and funded by the National Institute of Diabetes and Digestive, Kidney Diseases and National Center for Advancing Translational Sciences, and Otsuka America Pharmaceutical, Inc.

Author information

Authors and Affiliations

  1. Division of Nephrology and Hypertension, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Wisit Cheungpasitporn, Stephen B. Erickson & John C. Lieske

  2. Cardiorenal Department, Medical Affairs, Otsuka America Pharmaceutical, Inc., Princeton, NJ, USA

    Sandro Rossetti & Keith Friend

  3. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

    John C. Lieske

Authors
  1. Wisit Cheungpasitporn
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sandro Rossetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Keith Friend
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Stephen B. Erickson
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. John C. Lieske
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John C. Lieske.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 67 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Cheungpasitporn, W., Rossetti, S., Friend, K. et al. Treatment effect, adherence, and safety of high fluid intake for the prevention of incident and recurrent kidney stones: a systematic review and meta-analysis. J Nephrol 29, 211–219 (2016). https://doi.org/10.1007/s40620-015-0210-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40620-015-0210-4

Keywords

Search

Navigation