Abstract
Bacterial growth in the urinary tract is usually prevented by host factors including bacterial eradication by urinary and mucus flow, urothelial bactericidal activity, urinary secretory IgA, and blood group antigens in secretions which interfere with bacterial adherence. Bacterial eradication from the urinary tract is partially dependent on urine flow and voiding frequency. Therefore, it seems logical to postulate a connection between fluid intake and the risk of urinary tract infections (UTIs). However, experimental and clinical data on this subject are conflicting. Experimental studies concerning the effect of water intake on susceptibility and course of UTIs were predominantly performed in the 60 s and 70 s. Despite many open questions, there has been no continuous research in this field.
Only few clinical studies producing contradictory results are available on the influence of fluid intake concerning the risk of UTI. One explanation for the inconsistency between the data might be the uncertainty about the exact amounts of fluid intake, which was mostly recorded in questionnaires. So far, there is no definitive evidence that the susceptibility for UTI is dependent on fluid intake. Nevertheless, adequate hydration is important and may improve the results of antimicrobial therapy in UTI. Results of experimental and clinical studies concerning urinary hydrodynamics are the basis for advice given by expert committees to patients with UTI to drink large volumes of fluid, void frequently, and completely empty the bladder. The combination of the behaviourally determined aspects of host defence and not simply increasing fluid intake is important in therapy and prophylaxis of UTI.
This is a preview of subscription content, access via your institution
Access options
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Buy this article
- Purchase on Springer Link
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
Similar content being viewed by others
References
Adatto K, Doebele KG, Galland L & Granowetter L (1979): Behavioural factors and urinary tract infection. JAMA 241, 2525–2526.
Andriole VT (1966): Acceleration of the inflammatory response of the renal medulla by water diuresis. J. Clin. Invest. 45, 847–854.
Andriole VT (1970): Water, acidosis, and experimental pyelonephritis. J. Clin. Invest. 49, 21–30.
Andriole VT & Checko PJ (1968): Effect of water diuresis on chronic pyelonephritis. J. Lab. Clin. Med. 71, 1–16.
Andriole VT & Epstein FH (1965): Prevention of pyelonephritis by water diuresis: evidence for the role of medullary hypertonicity in promoting renal infection. J. Clin. Invest. 44, 73–79.
Asscher AW, Sussman M, Waters WE, Davis RH & Chick S (1966): Urine as a medium for bacterial growth. Lancet 2, 1037–1041.
Bailey RR (1994): Management of uncomplicated urinary tract infections. Int. J. Antimicrob. Agents 4, 95–100.
Borzone A, Iannace C, Vulpio C & Castiglioni GC (1988): Asymptomatic urinary hospital infections: choice of treatment with drinking water. Clin. Ter. 124, 183–186.
Catell WR, Fry IK, Spiro FI, Sardeson JM, Sutcliffe MB, O'Grady F & Path MRC (1970): Effect of diuresis and frequent micturition on the bacterial count of infected urine: a measure of competence of intrinsic hydrokinetic clearance mechanisms. Br. J. Urol. 42, 290–295.
Chambers ST & Kunin CM (1987): Isolation of glycine betaine and proline betaine from human urine: assessment of their role as osmoprotective agents for bacteria and the kidney. J. Clin. Invest. 79, 731–737.
Chernew I & Braude AI (1962): Depression of phagocytosis by solutes in concentrations found in the kidney and urine. J. Clin. Invest. 41, 1945–1953.
Cicmanec JF, Shank RA & Evans AT (1985): Overnight concentration of urine. Natural defence mechanism against urinary tract infection. Urology 26, 157–159.
Cox CE & Hinman F (1961): Experiments with induced bacteriuria, vesical emptying and bacterial growth on the mechanism of bladder defence to infection. J. Urol. 6, 739–748.
Denman SJ & Burton JR (1992): Fluid intake and urinary tract infection in the elderly. JAMA 267, 2245–2246.
Eckford SD, Keane DP, Lamond E, Jackson SR & Abrams P (1995): Hydration monitoring in the prevention of recurrent idiopathic urinary tract infections in pre-menopausal women. Br. J. Urol. 76, 90–93.
Ervine C, Komaroff AL & Pass TM (1980): Behavioural factors and urinary tract infection. JAMA 243, 330–331.
Friedman SA & Gladstone JL (1970): The effects of hydration and bladder incubation time on urine colony counts. J. Urol. 105, 428–432.
Gargan RA & Hamilton-Miller JMT (1994): Opsonophagocytosis in infected urine: relation to pH and osmolality. J. Urol. 152, 1615–1618.
Hampton MB, Chambers ST, Vissers MCM & Winterbourn CC (1994): Bacterial killing by neutrophily in hypertonic environments. J. Infect. Dis. 169, 839–846.
Harrison G, Cornsih J, Vanderwee MA & Miller TE (1988): Host defence mechanisms in the bladder I. Role of mechanical factors. Br. J. Exp. Pathol. 69, 245–254.
Hunt J & Waller G (1992): Psychological factors in recurrent uncomplicated urinary tract infection. Br. J. Urol. 69, 460–464.
Hunt J & Waller G (1994): The reliability of self-report of behaviours associated with recurrent urinary tract infection. Br. J. Urol. 74, 300–310.
Kaye D (1968): Antibacterial activity of human urine. J. Clin. Invest. 47, 2374–2390.
Kaye D (1975): Host defence mechanisms in the urinary tract. Urol. Clin. North. Am. 2, 407–422.
Kunin C.M. (1987): Detection, Prevention and Management of Urinary Tract Infections. Philadelphia: Lea & Febiger.
Lapides J, Costello RT, Zierdt DK & Stone TE (1968): Primary cause and treatment of recurrent urinary infection in women: preliminary report. J. Urol. 100, 552–555.
Lumsden L & Hyner GC (1985): Effects of an educational intervention on the rate of recurrent urinary tract infections in selected female outpatients. Women Health 10, 79–86.
Mannhardt W, Becker A, Putzer M, Zepp F, Hacker J & Schulte-Wissermann H (1996): Host defence within the urinary tract. I. Bacterial adhesion initiates uroepithelial defence mechanism. Pediatr. Nephrol. 10, 568–572.
McCormack M, Infant-Rivard C & Schick E (1992): Agreement between clinical methods of measurement of urinary frequency and functional bladder capacity. Br. J. Urol. 69, 7–21.
Mullholland SG & Bruun A (1973): A study of urinary tract infection. J. Urol. 110, 245–248.
Nielsen AF & Walter S (1979): Epidemiology of infrequent voiding and associated symptoms. Scand. J. Urol. Nephrol. 157(Suppl), 49–53.
Nygaard I & Linder M (1997): Thirst at work—an occupational hazard? Int. Urogynecol. J. Pelvic Floor Dysfunct. 8, 340–343.
O'Grady F & Cattell WR (1966a): Kinetics of urinary tract infection. II. The bladder. Br. J. Urol. 38, 156–162.
O'Grady F & Cattell WR (1966b): Kinetics of urinary tract infection. I. Upper urinary tract. Br. J. Urol. 38, 149–155.
Piercy KR, Khoury AE, McLorie GA & Churchill BM (1993): Diagnosis and management of pediatric urinary tract infection. Curr. Opin. Urol. 3, 25–29.
Pitt M (1989): Fluid intake and urinary tract infection. Nurs. Times 85, 36–38.
Prat V, Hatala M, Schuch O & Bohnslan V (1976): The influence of water diuresis on the course of experimental E. coli bacteriuria after unilateral nephrectomy in rats. Acta Biol. Med. Ger. 35, 1651–1656.
Remis RS, Gurwith MJ, Gurwith D, Hargrett-Bean NT & Layde PM (1987): Risk factors for urinary tract infection. Am. J. Epidemiol. 126, 686–694.
Rittig S, Matthiesen TB, Hunsballe JM, Pederson EB & Djurhuus JC (1995): Age-related changes in the circadian control of urine output. Scand. J. Urol. Nephrol. 173(Suppl), S71–S74.
Roberts AP, Robinson RE & Beard RW (1967): Some factors affecting bacterial colony counts in urinary infection. Br. Med. J. 1, 400–403.
Roberts JA (1996): Factors predisposing to urinary tract infections in children. Pediatr. Nephrol. 10, 517–522.
Schlager TA, Lohr JA & Hendley JO (1993): Antibacterial activity of the bladder mucosa. Urol. Res. 21, 313–317.
Schlegel JU, Cuellar J & O'Dell RM (1961): Bactericidal effect of urea. J. Urol. 86, 819–822.
Seddon JM, Bruce AW, Chadwick P & Carter D (1976): Introital bacterial flora—effect of increased frequency of micturition. Br. J. Urol. 48, 211–218.
Seddon JM, Bruce AW, Chadwick P & Willett WS (1980): Frequency of micturition and urinary tract infection. J. Urol. 123, 524–526.
Smellie JM, Grüneberg RN, Bantock HM & Prescod N (1988): Prophylactic co-trimoxazole and trimethoprim in the management of urinary tract infection in children. Pediatr. Nephrol. 2, 12–17.
Spach DH, Stapleton AE & Stamm W (1993): Behavioral and genetic factors related to urinary tract infection. Curr. Opin. Infect. Dis. 6, 31–35.
Sobel JD & Kaye D (1990): Urinary tract infections. In Principles and Practice of Infectious Diseases. (3rd Edition) eds GL Mandell, RG Douglas & JE Bennett. New York: Churchill Livingstone.
Winberg J, Anderson T, Bergstrom H, Larson H & Lincoln K (1974): Epidemiology of symptomatic urinary tract infection in childhood. Acta Paediatr. Scand (Suppl.) 252, 1–20.
Ziesche HW (1966): Oligurie und Harnwegsinfekt. Z. Urol. Nephrol. 5, 625–631.
Author information
Authors and Affiliations
Contributions
Guarantor: R Beetz.
Contributors: None.
Corresponding author
Rights and permissions
About this article
Cite this article
Beetz, R. Mild dehydration: a risk factor of urinary tract infection?. Eur J Clin Nutr 57 (Suppl 2), S52–S58 (2003). https://doi.org/10.1038/sj.ejcn.1601902
Published:
Issue Date:
DOI: https://doi.org/10.1038/sj.ejcn.1601902
Keywords
This article is cited by
-
WaSH insecurity and anxiety among people who inject drugs in the Tijuana-San Diego border region
BMC Public Health (2024)
-
The Management of Recurrent Urinary Tract Infection: Non-Antibiotic Bundle Treatment
Probiotics and Antimicrobial Proteins (2023)
-
Ex vivo LPS-stimulated cytokine production is associated with hydration status in community-dwelling middle-to-older-aged adults
European Journal of Nutrition (2023)
-
Association between antihypertensive medication and the risk of urinary tract infection (UTI) of outpatients: a retrospective cohort study
Infection (2023)
-
Ist die antibakterielle Langzeitprophylaxe immer noch alternativlos?
Der Urologe (2020)