Kidney Res Clin Pract.  2019 Jun;38(2):196-204. 10.23876/j.krcp.18.0147.

Sub-morbid dehydration-associated glomerular hyperfiltration: An emerging reality?

• Min HK
• Sung SA
• Lee SY
• Lee SW

• KMID: 2451869
• DOI: http://doi.org/10.23876/j.krcp.18.0147

Abstract

BACKGROUND
Severe dehydration decreases renal perfusion. However, it is unclear whether sub-morbid dehydration affects kidney function similarly. Although there have been numerous animal and human studies that have suggested mild dehydration is associated with glomerular hyperfiltration, it has not been confirmed on a large-scale in the general population. Therefore, we aimed to identify the relationship between hydration status and kidney function.
METHODS
We reviewed the data of 28,342 adults who participated in the Korea National Health and Nutrition Examination Surveys. Urine specific gravity unit (SGU) was the primary variable that indicated hydration status, and the estimated glomerular filtration rate (eGFR) was used as the primary outcome.
RESULTS
Multivariate linear regression analysis showed urine SGU was positively associated with eGFR, which was J-shaped in the multivariate generalized additive model plot. In the penalized spline curve analysis, the odds ratio for high eGFR was steadily increased. Although increased urine SGU was associated with decreased blood pressure and pulse rate, it had no effect on increased fasting glucose and total cholesterol, suggesting conflicting cardio-metabolic dehydration effects.
CONCLUSION
Dehydration, presumably sub-morbid in an ambulatory community-dwelling general population, is associated with higher kidney function. The clinical significance of sub-morbid dehydration-associated glomerular hyperfiltration needs further investigation.

Keyword

Chronic renal insufficiency; Dehydration; Glomerular hyperfiltration; Organism hydration status; Urine specific gravity

MeSH Terms

Adult
Animals
Blood Pressure
Cholesterol
Dehydration
Fasting
Glomerular Filtration Rate
Glucose
Heart Rate
Humans
Kidney
Korea
Linear Models
Odds Ratio
Perfusion
Renal Insufficiency, Chronic
Specific Gravity
Cholesterol
Glucose