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, @entity1 , _ MEASUREMENTS: This prospective cohort study was undertaken in Canada from 2002 to 2008. We obtained 24-hour urine samples from adult @entity1 with an estimated @entity5017 (eGFR) >= 60 ml/min per 1.73 m(2) at study entry. Percentage annual change in eGFR from baseline was categorized as average decline <1% per year, between 1% and 4.9% (mild-to-moderate decline) or >= 5% (rapid decline). RESULTS: 2148 @entity1 provided valid 24-hour urine samples, grouped as <1 L/d (14.5%); 1 to 1.9 L/d (51.5%); 2 to 2.9 L/d (26.3%); and >= 3 L/d (7.7%). Baseline eGFR for each category of urine volume was 90, 88, 84, and 87 ml/min per 1.73 m(2), 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 L/d, 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 @entity101 (including diuretics), @entity644 , @entity6 , and @entity65 . CONCLUSIONS: In this community-based cohort, decline in kidney function was significantly slower in those with higher versus lower urine volume.

Urine volume and change in estimated XXXX in a community-based cohort study.

@entity1 :: ('9606', 'Species') :: ['participants', 'PARTICIPANTS'] @entity644 :: ('MESH:D011507', 'Disease') :: ['proteinuria'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity5017 :: ('9771', 'Gene') :: ['GFR'] @entity65 :: ('MESH:D002318', 'Disease') :: ['cardiovascular disease']
@entity5017 :: (9771,Gene) :: ['GFR']
