par Nutrimuscle-Conseils » 31 Mar 2015 11:30
TREATMENT EFFECT AND SAFETY OF HIGH FLUID INTAKE FOR THE PREVENTION OF INCIDENT AND RECURRENT KIDNEY STONES: A META-ANALYSIS
Wisit Cheungpasitporn Mayo Clinic, Rochester, MN, USA.
The objectives of this meta-analysis were to evaluate the treatment
effect of high fluid intake on the incidence of kidney stones, and to
assess the compliance and safety of high fluid intake to prevent kidney
stones.
A literature search was performed from inception through July 2014.
Studies that reported relative risks, odds ratios or hazard ratios
comparing the risk of kidney stones in patients with high fluid intake vs
inadequate fluid intake were included. Pooled risk ratios (RR) and 95%
confidence intervals (CI) were calculated using a random-effect,
generic inverse variance method.
Nine studies (2 randomised controlled trials [RCTs]; 7 observational
studies) with 273,954 patients were included in the meta-analysis. The
pooled RRs of kidney stones in patients 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 also
significantly associated with reduced recurrent kidney stone risk, with
RRs of 0.40 (95% CI 0.20–0.79) and 0.20 (0.09–0.44) in RCTs and
observational studies, respectively. Data on compliance and safety of
high fluid intake treatment were limited; 1 RCT reported no
withdrawals due to adverse events.
This meta-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 (~0.5 in both
cases) was high. Although increased fluid intake appears to be safe,
future studies on its safety in patients with high risk of volume overload
or hyponatremia are warranted.
