The relationship between water intake and progressivity Glomerular filtration rate of chronic kidney disease patients

Introduction and objectives: The increasing incidence of chronic kidney disease in Indonesia and several previous studies assessing the relationship of water intake by evaluating all inputs including total daily water intake as well as output (urine volume) found that there is a role of fluid input on the progressivity of CKD which shows that patients who drink too much or little water tend to progress the failure of kidney function faster so we raised this study to determine and important implications for education of CKD patients regarding water intake. Methods: This prospective observational study entails the enrollment of CKD stage 3a, 3b and 4 outpatients from Hypertension Kidney Poluclinic at Dr. Wahidin Sudirohusodo Hospital and Makassar Satellite Hospital, The search for research subjects from October to December 2023 (11 subjects), followed by observation and data collection lasted for a duration of 3 months (10 subjects) and was analyzed from March to April 2024. The daily average water intake was measured using a 2-liter tumbler and 24-hour urine volume was measured using a chamber pot and the results were recorded in a food diary. Creatinine levels (LFG) were collected from red blood cells and urine osmolarity from 24-hour urine. Results: The correlation between average daily water intake and delta creatinine was r= 0.151 (p=0.677), average daily water intake and delta eLFG was r=-0.196 (p=0.588), average daily water intake , 24-hour total urine volume was r=0.625 (p=0.053), average daily water intake and delta urine osmolarity was r= 0.608 (p=0.062). A p-value exceed- ing 0.05 indicates an insignificant correlation. Conclusions: The physiological function of the kidneys can still function properly as evidenced by the amount of wa- ter given where the more the amount of water drunk, the more the amount of urine and urine osmolarity decreases. This study has not been able to prove the research hypothe- sis with research limitations.