Mechanisms by Which Dehydration May Lead to Chronic Kidney Disease

Dehydration, a condition that characterizes excessive loss of body water, is well known to be associated with acute renal dysfunction; however, it has largely been considered reversible and to be associated with no long-term effects on the kidney. Recently, an epidemic of chronic kidney disease has...

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Bibliographic Details
Published in:Annals of nutrition and metabolism 2015-01, Vol.66 (Suppl 3), p.10-13
Main Authors: Roncal-Jimenez, C., Lanaspa, M.A., Jensen, T., Sanchez-Lozada, L.G., Johnson, R.J.
Format: Article
Language:English
Subjects:
Aldehyde Reductase - metabolism
Aldose reductase
Central America
Chronic illnesses
Chronic kidney failure
Dehydration
Dehydration (Physiology)
Dehydration - complications
Dehydration - physiopathology
Dehydration - therapy
Disease Progression
Drinking (Physiology)
Epidemics
Fluid Therapy
Fructokinases - metabolism
Fructose
Heat Exhaustion - complications
Humans
Hyperuricemia - complications
Kidney diseases
Kidneys
Metabolic Networks and Pathways
Osmolar Concentration
Oxidative stress
Proceedings
Recurrence
Renal function
Renal Insufficiency, Chronic - etiology
Renal Insufficiency, Chronic - prevention & control
Risk factors
Uric acid
Vasopressins - metabolism
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Summary:Dehydration, a condition that characterizes excessive loss of body water, is well known to be associated with acute renal dysfunction; however, it has largely been considered reversible and to be associated with no long-term effects on the kidney. Recently, an epidemic of chronic kidney disease has emerged in Central America in which the major risk factor seems to be recurrent heat-associated dehydration. This has led to studies investigating whether recurrent dehydration may lead to permanent kidney damage. Three major potential mechanisms have been identified, including the effects of vasopressin on the kidney, the activation of the aldose reductase-fructokinase pathway, and the effects of chronic hyperuricemia. The discovery of these pathways has also led to the recognition that mild dehydration may be a risk factor in progression of all types of chronic kidney diseases. Furthermore, there is some evidence that increasing hydration, particularly with water, may actually prevent CKD. Thus, a whole new area of investigation is developing that focuses on the role of water and osmolarity and their influence on kidney function and health.
ISSN:0250-6807
1421-9697
DOI:10.1159/000381239