Rangan et al. 2024
Long-term effect of increasing water intake on repeated self-assessed health-related quality of life (HR-QoL) in autosomal dominant polycystic kidney disease
Abstract
Background
The aim of this study was to determine the long-term effect of increasing water intake in patients with autosomal dominant polycystic kidney disease (ADPKD) on longitudinal changes in HR-QoL in the setting of a clinical trial.
Methods
Self-completed HR-QoL (using the KDQoL-SF, v1.3 questionnaire) was assessed annually in participants of a 3-year randomised controlled clinical trial (n = 187), allocated (1:1) either to increase water intake to reduce urine osmolality to ≤270 mosmol/kg (implemented by dietetic coaching, self-monitoring tools, text messaging) or continue usual water intake.
Results
Overall, 96% and 81.8% of participants (n = 187) completed the questionnaire at the baseline and final study visits, respectively. At baseline, the physical component summary score (PCS) and mental component summary score (MCS) were similar in the two groups (P > 0.05) and the five dimensions with the lowest scores in both groups were: energy and fatigue; general and overall health; sleep; emotional well-being; and pain. Within each group, there were no longitudinal changes over time. At the final visit, the PCS was higher in the increased water intake group (51.3 ± 7.6, mean ± standard deviation) compared to the usual water intake group 48.8 ± 9.3; P = 0.037) whereas the MCS was numerically similar. The improvement in the PCS was due to higher sub-scale values for physical functioning and pain (both P < 0.05). By multivariate analysis, only baseline PCS and height-corrected total kidney volume were associated with the final PCS (P < 0.05).
Conclusions
HR-QoL scores remained stable over a 3 year period, and were not adversely affected by the intervention to increase water intake. Future studies should evaluate the clinical significance of the higher PCS in the increased water intake group.
A word from our expert, Dr Gopala Rangan:
"This is the first long-term study to evaluate the role of increased water intake of healthrelated quality of life. This study suggests that advising patients to increase water intake does not have any detrimental effects on quality of life and may have positive benefits on pain and physical functioning which should investigated in future studies."*
*Gopala Rangan, Margaret Allman-Farinelli, Neil Boudville, Mangalee Fernando, Imad Haloob, David C H Harris, Carmel M Hawley, Karthik Kumar, David W Johnson, Vincent W Lee, Jun Mai, Anna Rangan, Simon D Roger, Priyanka Sagar, Kamal Sud, Vicente Torres, Eswari Vilayur, Long-term effect of increasing water intake on repeated self-assessed health-related quality of life (HR-QoL) in autosomal dominant polycystic kidney disease, Clinical Kidney Journal, 2024;, sfae159, https://doi.org/10.1093/ckj/sfae159
