ArticlePloS one2014
Urine osmolarity and risk of dialysis initiation in a chronic kidney disease cohort--a possible titration target?
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 36 citations in OpenAlex.
- Trial
- Impact of recurrent dehydration with mild periodic water restriction on blood pressure and renal function in male spontaneously hypertensive rats.Experimental physiology · 2026Article
- Association between hydration status and the risk and all-cause mortality of diabetic kidney disease.Renal failure · 2024Article
- Is mild dehydration a risk for progression of childhood chronic kidney disease?Pediatric nephrology (Berlin, Germany) · 2024Review
- Low daily water intake profile-is it a contributor to disease?Nutrition and health · 2024Review
- Water intake, baseline biopsy, and graft function after living donor kidney transplantation.Scientific reports · 2024Article
- The association of urine osmolality with decreased kidney function and/or albuminuria in the United States.BMC nephrology · 2021Article
- Possible role of L-form switching in recurrent urinary tract infection.Nature communications · 2019Article
- Sub-morbid dehydration-associated glomerular hyperfiltration: An emerging reality?Kidney research and clinical practice · 2019Article
- Urinary Concentration Ability: Time to Bring the Tubules to the Table.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2019Article
- Metabolic and Kidney Diseases in the Setting of Climate Change, Water Shortage, and Survival Factors.Journal of the American Society of Nephrology : JASN · 2016Article
- Feeding soy protein isolate and oils rich in omega-3 polyunsaturated fatty acids affected mineral balance, but not bone in a rat model of autosomal recessive polycystic kidney disease.BMC nephrology · 2015Article
- PSHREG: a SAS macro for proportional and nonproportional subdistribution hazards regression.Computer methods and programs in biomedicine · 2015Article
- Augmented backward elimination: a pragmatic and purposeful way to develop statistical models.PloS one · 2014Article
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Authors and funding
7 authors at 3 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIncreasing evidence is linking fluid intake, vasopressin suppression and osmotic control with chronic kidney disease progression. Interestingly, the association between urine volume, urine osmolarity and risk of dialysis initiation has not been studied in chronic kidney disease patients before.
objectiveTo study the relationship between urine volume, urine osmolarity and the risk of initiating dialysis in chronic kidney disease.
designIn a retrospective cohort analysis of 273 patients with chronic kidney disease stage 1-4 we assessed the association between urine volume, urine osmolarity and the risk of dialysis by a multivariate proportional sub-distribution hazards model for competing risk data according to Fine and Gray. Co-variables were selected via the purposeful selection algorithm.
resultsDialysis was reached in 105 patients over a median follow-up period of 92 months. After adjustment for age, baseline creatinine clearance, other risk factors and diuretics, a higher risk for initiation of dialysis was found in patients with higher urine osmolarity. The adjusted sub-distribution hazard ratio for initiation of dialysis was 2.04 (95% confidence interval, 1.06 to 3.92) for each doubling of urine osmolarity. After 72 months, the estimated adjusted cumulative incidence probabilities of dialysis were 15%, 24%, and 34% in patients with a baseline urine osmolarity of 315, 510, and 775 mosm/L, respectively.
conclusionsWe conclude that higher urine osmolarity is associated with a higher risk of initiating dialysis. As urine osmolarity is a potentially modifiable risk factor, it thus deserves further, prospective research as a potential target in chronic kidney disease progression.
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