CMAJ • January 15, 2008; 178 (2). doi:10.1503/cmaj.070792.
© 2008 Canadian Medical Association or its licensors
All editorial matter in CMAJ represents the opinions of the authors and not necessarily those of the Canadian Medical Association.
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Research

Research letter

Excessive fluid intake as a novel cause of proteinuria

William F. Clark, MD, Claude Kortas, MD MEd, Rita S. Suri, MD MSc, Louise M. Moist, MD MSc, Marina Salvadori, MD, Matt A. Weir, MD, Amit X. Garg, MD PhD for the WEL Investigators

From the Department of Medicine (Nephrology), London Health Sciences Centre (Clark, Kortas, Suri, Moist, Weir, Garg), and the Division Infectious Diseases, Children's Hospital of Western Ontario (Salvadori), University of Western Ontario, London, Ont.
WEL (Walkerton E. coli Long-term) Investigators: William F. Clark, Rita S. Suri, Louise M. Moist, Amit X. Garg and John Howard, Department of Medicine (Nephrology), London Health Sciences Centre, London, Ont.; Marina Salvadori, Division of Infectious Diseases, Children's Hospital of Western Ontario, London, Ont.; and Douglas Matsell, Department of Pediatrics, University of British Columbia, Vancouver, BC

Correspondence to: Dr. William F. Clark, Department of Medicine (Nephrology), London Health Sciences Centre, Rm. A2-343, 800 Commissioners Rd. E, London ON N6A 4G5; fax 519 685-8047; william.clark{at}lhsc.on.ca

As part of a community screening study to assess the long-term health outcomes among residents of Walkerton, Ontario, after contamination of its municipal water supply by Escherichia coli O157:H7 and Campylobacter in 2000, we identified 100 adults who had proteinuria and polyuria but no medical history or medication use to explain their condition. Fifty-six of the 100 participants underwent both initial and confirmatory urine concentration tests, which showed that their urine osmolality could reach normal levels. We then instructed them to reduce their fluid intake to less than 2 L/d for 1 week. The proteinuria and polyuria were largely reversed by this manoeuvre. We do not know at this time whether the proteinuria associated with excessive fluid intake in these otherwise healthy people will affect their kidney function in the long term.




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Considering Helicobacter for unexplained proteinuria
Ehsan Chitsaz
CMAJ, 22 Feb 2008 [Full text]