Kidney Res Clin Pract 2019 Jun; 38(2): 196-204  
Sub-morbid dehydration-associated glomerular hyperfiltration: An emerging reality?
Hyang Ki Min , Su Ah Sung , So Young Lee , Sung Woo Lee
Department of Internal Medicine, Eulji Medical Center, Eulji University, Seoul, Korea
Correspondence to: Sung Woo Lee
Division of Nephrology, Department of Internal Medicine, Eulji Medical Center, 68 Hangeulbiseok-ro, Nowon-gu, Seoul 01735, Korea. E-mail: neplsw@gmail.com
Received: November 29, 2018; Revised: February 1, 2019; Accepted: February 20, 2019; Published online: June 30, 2019.
© The Korean Society of Nephrology. All rights reserved.

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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.
Keywords: Chronic renal insufficiency, Dehydration, Glomerular hyperfiltration, Organism hydration status, Urine specific gravity


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