High water vs. ad libitum water intake for autosomal dominant polycystic kidney disease: a randomized controlled feasibility trial

El-Damanawi, Ragada; Lee, M; Harris, T; Cowley, Laura; Bond, Simon; Pavey, Holly; Sandford, Richard; Wilkinson, Ian B.; Karet, Fiona E.; Hiemstra, Thomas F.

doi:10.1093/qjmed/hcz326

Cited by 5 publications

(5 citation statements)

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“…This novel and, to our knowledge, unique model allows patients and the public not only to propose research questions, but to design, initiate, and deliver their own research with available expert support from researchers. The PLRH has proved the feasibility of such a design by successfully publishing an RCT 16 . Orthopaedic research groups could benefit from a similar model, especially in the arena of quality-of-life outcomes, where patient opinion is of paramount value.…”

Section: Ppi Successes Outside Of Orthopaedic Researchmentioning

confidence: 99%

Patient and Public Involvement Within Orthopaedic Research

Owyang

Bakhsh

Brewer

et al. 2021

Journal of Bone and Joint Surgery

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Background:We performed a systematic review of patient and public involvement in randomized controlled trials (RCTs) in the field of orthopaedic surgery. We assessed the prevalence, extent, and quality of patient and public involvement (PPI) in current academic orthopaedic practice.Methods:A literature search of the Cochrane, MEDLINE, and Embase databases was performed; we identified RCTs that were published between 2013 and 2020 in the 10 orthopaedic surgery journals with the highest impact factors. Inclusion of studies was based on set criteria, and they were analyzed for their validity. The results were assessed for the rate and the quality of PPI reporting. The Wright and Foster guidelines and the GRIPP2-SF (Guidance for Reporting Involvement of Patients and the Public-2 short form) checklist were used to assess PPI reporting. This review was reported in line with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines.Results:An initial 2,107 results were identified. After the screening process, 475 full-text articles were identified and reviewed. Two papers that described PPI were included in this review. One paper used PPI to inform the research question, the choice of primary outcome, the oversight of the study schedule, and the dissemination of the results. The second article used PPI to design the study protocol. Both articles poorly reported the impact of PPI on the research.Conclusions:To our knowledge, this systematic review is the first to describe the prevalence, extent, and quality of PPI reporting in orthopaedic RCTs. Barriers to adequate PPI reporting are multifactorial and stem from a lack of systematic uptake of PPI guidelines and a lack of compulsory PPI reporting from publishing bodies.Clinical Relevance:PPI can improve the quality of clinical trials by focusing on the clinical questions and outcomes that are most important to patients. This article assesses the prevalence of PPI reporting in orthopaedic RCTs.

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Section: Ppi Successes Outside Of Orthopaedic Researchmentioning

confidence: 99%

Patient and Public Involvement Within Orthopaedic Research

Owyang

Bakhsh

Brewer

et al. 2021

Journal of Bone and Joint Surgery

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“…Home monitoring of urine-specific gravity was employed to promote adherence. Despite a difference in urine volume and – osmolality at week 8, copeptin values were not different at this time point [67 ▪ ].…”

Section: Water and Osmolar Intakementioning

confidence: 64%

Emerging non-pharmacological interventions in ADPKD: an update on dietary advices for clinical practice

Meijer¹,

Gansevoort²

2021

Current Opinion in Nephrology &Amp; Hypertension

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Purpose of reviewPatients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) reach kidney failure at a median age of 58 years. There has been a strong interest in medical interventions to improve prognosis. With increasing understanding of the underlying pathophysiology, there is also a rationale for nonpharmaceutical interventions. However, these have received little attention. This review, therefore, focuses on dietary interventions in ADPKD. Recent findingsRecent studies regarding salt, protein and water intake, caloric restriction, BMI, caffeine and alcohol are discussed in this review. In general, these studies suggest that advices do not need to be different from those in chronic kidney disease (CKD). On the basis of research in the general population and CKD, these advices will likely decrease cardiovascular morbidity and mortality. With respect to delaying ADPKD progression, evidence for salt restriction is growing. For increasing water intake and targeting glucose metabolism by intermittent fasting, preclinical studies are promising. Long-term randomized human intervention studies are, however, lacking.

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“…A oneyear trial in Canadian patients with CKD showed no benefit of HWI for kidney protection in spite of monthly coaching [28]. In this and several other HWI trials, fluid intake was lesser than prescribed [28,149,150]. This is also the case in patients with recurrent urolithiasis, in spite of their painful symptoms [151,152].…”

Section: Which Strategy Should Be Most Effective For Reducing V2rmedi...mentioning

confidence: 90%

Vaptans or voluntary increased hydration to protect the kidney: how do they compare?

Bankir

Guerrot

Bichet

2021

Nephrology Dialysis Transplantation

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The adverse effects of vasopressin (AVP) in diverse forms of chronic kidney disease have been well described. They depend on the antidiuretic action of AVP mediated by V2 receptors (V2R). Treatment with tolvaptan, a selective V2R antagonist, is now largely used for the treatment of patients with ADPKD. Another way to reduce the adverse effects of AVP is to reduce endogenous AVP secretion by voluntary increase in fluid intake. These two approaches differ in several ways, including the level of thirst and AVP. With voluntary increased drinking plasma osmolality will decline and so will AVP secretion. Thus, not only will V2R-mediated effects be reduced, but also those mediated by V1a (V1aR) and V1b receptors. In contrast, selective V2R antagonism will induce a loss of fluid that will stimulate AVP secretion and thus, increase AVP's influence on V1a and V1b receptors. V1aR are expressed in the luminal side of the collecting duct and in inner medullary interstitial cells, and their activation induces the production of prostaglandins, mostly PGE2. Intrarenal PGE2 have been shown to reduce sodium and water reabsorption in the collecting duct and to increase blood flow in the renal medulla, both effects contributing to increase sodium and water excretion and reduce urine concentrating activity. Conversely, non-steroidal anti-inflammatory drugs have been shown to induce a significant water and sodium retention and potentiate the antidiuretic effects of AVP. Thus, during V2R antagonism, V1aR-mediated actions may be responsible for part of the diuresis observed with this drug. These V1aR-dependent effects do not take place with voluntary increase in fluid intake. In summary, while both strategies may have beneficial effects, the information reviewed here lead us to assume that the pharmacological V2R antagonism, with resulting stimulation of V1aR and increased PGE2 production, may provide greater benefit than voluntary HWI. The influence of tolvaptan on PGE2 excretion rate and the possibility to use somewhat lower tolvaptan doses than presently prescribed remain to be evaluated.

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High water vs. ad libitum water intake for autosomal dominant polycystic kidney disease: a randomized controlled feasibility trial

Cited by 5 publications

References 0 publications

Patient and Public Involvement Within Orthopaedic Research

Patient and Public Involvement Within Orthopaedic Research

Emerging non-pharmacological interventions in ADPKD: an update on dietary advices for clinical practice

Vaptans or voluntary increased hydration to protect the kidney: how do they compare?

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