***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: High fluid intake is the only preventive dietary measure that can be recommended to all patients with stones . However , the efficacy of dietary advice given to patients is unknown . We compared the impact of dietary advice to increase hydration  ( group 1 , 57 patients ) and of no dietary advice  ( group 2 , 83 patients ) on 24-hour urine volume . No significant difference was noted between groups 1 ( 1,624 ml . ) and 2 ( 1,732 ml . ) . We then determined if urine specific gravity dipsticks could help patients increase the 24-hour urine volume . A correlation between 24-hour urine volume and mean urine specific gravity was performed on 263 r and omly chosen patients . There was an inverse relationship between urine specific gravity and 24-hour urine volume with a correlation coefficient of 0.522 ( y = 1.0207 - 0.00374x ) . Most patients ( 81.6 % ) with 24-hour urine volumes of less than 2.1 had a urine specific gravity of more than 1.010 . The use of specific gravity dipsticks was evaluated as a tool to help 24 patients increase the 24-hour urine volume . The 24-hour urine volume increased significantly ( p less than 0.05 , paired Student 's t test ) in patients after feedback from specific gravity dipsticks when they were instructed to keep the urine specific gravity at or less than 1.010 ( average 24-hour urine volume increased 192 % ) . We conclude that dietary advice may be insufficient to modify fluid intake habits in stone patients . However , modifications of fluid intake habits may be improved by feedback from specific gravity dipsticks Background and objectives Increased water intake may benefit kidney function . Prior to initiating a larger r and omised controlled trial ( RCT ) , we examined the safety and feasibility of asking adults with chronic kidney disease ( CKD ) to increase their water intake . Design , setting , participants and measurements Beginning in October 2012 , we r and omly assigned 29 adults with stage 3 CKD ( estimated glomerular filtration rate ( eGFR ) 30–60 mL/min/1.73 m2 and albuminuria ) to one of the two groups of water intake : hydration ( n=18 ) or  st and ard  ( n=11 ) . We asked the hydration group to increase their water intake by 1.0–1.5 L/day ( in addition to usual intake , depending on sex and weight ) for 6 weeks , while the control group carried on with their usual intake . Participants collected a 24 h urine sample at baseline and at 2 and 6 weeks after r and omisation . Our primary outcome was the between-group difference in change in 24 h urine volume from baseline to 6 weeks . Results (63%)of participants were men , 81 % were Caucasians and the average age was 61 years ( SD 14 years ) . The average baseline eGFR was 40 mL/min/1.73 m2 ( SD 11 mL/min/1.73 m2 ) ; the median albumin to creatinine ratio was 19 mg/mmol ( IQR 6–74 mg/mmol ) . Between baseline and 6-week follow-up , the hydration group 's average 24 h urine volume increased by 0.7 L/day ( from 2.3 to 3.0 L/day ) and the control group 's 24 h urine decreased by 0.3 L/day ( from 2.0 to 1.7 L/day ; between-group difference in change : 0.9 L/day ( 95 % CI 0.4 to 1.5 ; p=0.002 ) ) . We found no significant changes in urine , serum osmolality or electrolyte concentrations , or eGFR . No serious adverse events or changes in quality of life were reported . Conclusions A pilot RCT indicates adults with stage 3 CKD can successfully and safely increase water intake by up to 0.7 L/day in addition to usual fluid intake . Trial registration Registered with Clinical Trials — government identifier NCT01753466 OBJECTIVES Several animal studies have shown that bladder performance improves as a result of diuresis . Whether increased urine output also has beneficial effects on elderly male bladder function and lower urinary tract symptoms is unknown . METHODS We performed a r and omized placebo-controlled trial of 141 men , 55 to 75 years of age , with moderate lower urinary tract symptoms . The experimental group drank 1.5 L of extra water daily . The control group consumed one tablespoon of placebo syrup daily . After 6 months , we evaluated bladder contractility , voided volumes , and the severity of lower urinary tract symptoms . The actual increase in water consumption was measured using the deuterium urine dilution method . RESULTS Water consumption in the intervention group increased by 359 mL ( 95 % confidence interval [ CI ] 171 to 548 ) per 24 hours compared with the control group . At 6 months , no statistically significant effect was found in the maximal flow rate ( 0.9 mL/s , 95 % CI -0.4 to 2.2 ) compared with placebo . A statistically significant effect was found for bladder pressure ( 20 cm H2O , 95 % CI 6 to 34 ) and bladder wall stress ( 1.9 N/cm2 , 95 % CI 0.3 to 3.5 ) . In addition , it showed that the experimental group had greater maximal ( 44 mL , 95 % CI -1 to 90 ) and average ( 26 mL , 95 % CI 1 to 51 ) voided volumes per urination . The subjective effect parameters improved in both groups , but no statistically significant differences were found between the two groups . CONCLUSIONS It seems possible to improve some aspects of male bladder function by drinking more water . However , the effects are too small to be clinical ly relevant Background : Nephrolithiasis is a recurrent disease , and one of the most effective methods for prevention of stone recurrence is increasing the urine output ( > 2 L/day ) , but it is difficult to achieve it . The aim of this study was to evaluate the effect of behavioral intervention by measurement of urine specific gravity using dipstick on 24-h urine volume in first renal stone patients . Material s and Methods : In this prospect i ve r and omize clinical study , 80 adult patients with history of first renal stone were included . Patients were divided into two groups with 40 patients in each group . We explained the importance of high fluid intake and high urine volume in the prevention of renal stones for all patients . Group A patients were trained to measure 24-h urine volume every 15 days , and group B patients were trained to keep urine specific gravity below 1.010 by using dipstick . We measured 24-h urine volume in each group before intervention , and at 3 months and 6 months after intervention and compared them . Results : There were no significant differences between the two groups in 24-h urine volume before intervention ( P = 0.41 ) , but it was significant 3 months ( P = 0.01 ) and 6 months ( P = 0.01 ) after intervention . Patients ′ compliance was 20 % in group A and 90 % in group B ( P < 0.05 ) . Conclusion : The use of behavioral modification with dipstick is an effective method for control and maintenance of optimal urine volume , and it has result ed in more patient compliance for drinking water and is more effective for prevention of renal stone Dehydration is commonly believed to result in headache , but the effectiveness of increasing the water intake in patients who frequently suffer from headaches has not been studied thus far . In a pilot study , we examined the possible effects and feasibility of increased water intake in headache patients . Eighteen headache patients ( all had migraine , two also had tension-type headache ) were r and omly allocated to placebo medication , or the advice to additionally drink 1.5 l of water per day , for a period of 12 weeks . Effect measurements consisted of a 2 weeks headache diary and the Migraine Specific Quality of Life ( MSQOL ) question naire . The advice to increase the daily fluid intake by 1.5 l increased the fluid intake in the intervention group by approximately 1 l. This reduced the total hours of headache in 2 weeks by 21 h ( 95 % CI : -48 to 5 ) . Mean headache intensity decreased by 13 mm ( 95 % CI : -32 to 5 ) on a visual analogue scale ( VAS ) . The effects on MSQOL , number of headache episodes , and medication seemed to be small . The data of the present study suggest a reduction in the total number of hours and intensity of headache episodes after increased water intake . Our results seem to justify larger scaled research on the effectiveness of increased water intake in headache patients PURPOSE We define the role of urine volume as a stone risk factor in idiopathic calcium stone disease and test the actual preventive effectiveness of a high water intake . MATERIAL S AND METHODS We studied 101 controls and 199 patients from the first idiopathic calcium stone episode . After a baseline study period the stone formers were divided by r and omization into 2 groups ( 1 and 2 ) and they were followed prospect ively for 5 years . Followup in group 1 only involved a high intake of water without any dietetic change , while followup in group 2 did not involve any treatment . Each year clinical , laboratory and radiological evaluation was obtained to determine urinary stone risk profile ( including relative supersaturations of calcium oxalate , brushite and uric acid by Equil 2 ) , recurrence rate and mean time to relapse . RESULTS The original urine volume was lower in male and female stone formers compared to controls ( men with calcium oxalate stones 1,057 + /- 238 ml./24 hours versus normal men 1,401 + /- 562 ml./24 hours , p < 0.0001 and women calcium oxalate stones 990 + /- 230 ml./24 hours versus normal women 1,239 + /- 440 ml./24 hours , p < 0.001 ) . During followup recurrences were noted within 5 years in 12 of 99 group 1 patients and in 27 of 100 group 2 patients ( p = 0.008 ) . The average interval for recurrences was 38.7 + /- 13.2 months in group 1 and 25.1 + /- 16.4 months in group 2 ( p = 0.016 ) . The relative supersaturations for calcium oxalate , brushite and uric acid were much greater in baseline urine of the stone patients in both groups compared to controls . During followup , baseline values decreased sharply only in group 1 . Finally the baseline urine in patients with recurrences was characterized by a higher calcium excretion compared to urine of the patients without recurrences in both groups . CONCLUSIONS We conclude that urine volume is a real stone risk factor in nephrolithiasis and that a large intake of water is the initial therapy for prevention of stone recurrences . In cases of hypercalciuria it is suitable to prescribe adjuvant specific diets or drug therapy BACKGROUND Previously published investigations suggest a positive effect of increased water intake on headache , but a r and omised controlled trial has not been done . OBJECTIVE To investigate the effects of increased water intake on headache . METHODS R and omised controlled trial in primary care with two groups and a follow-up period of 3 months . Patients were included if they had at least two episodes of moderately intense headache or at least five mildly intense episodes per month and a total fluid intake of less than 2.5 l/day . Both groups received written instructions about stress reduction and sleep improvement strategies . The intervention group additionally received the instruction to increase the daily water intake by 1.5 l. The main outcome measures were Migraine-Specific Quality of Life ( MSQOL ) and days with at least moderate headache per month . RESULTS We r and omised 50 patients to the control group and 52 patients to the intervention group . Drinking more water result ed in a statistically significant improvement of 4.5 ( confidence interval : 1.3 - 7.8 ) points on MSQOL . In addition , 47 % in the water group reported much improvement ( 6 or higher on a 10-point scale ) on perceived intervention effect against 25 % in the control group . However , drinking more water did not result in relevant changes in days with at least moderate headache . CONCLUSIONS Considering the observed positive subjective effects , it seems reasonable to recommend headache patients to try this non-invasive intervention for a short period of time to see whether they experience improvement Maintenance of weight loss remains a challenge for most individuals . Thus , practical and effective weight-loss maintenance ( WTLM ) strategies are needed . A two-group 12-month WTLM intervention trial was conducted from June 2007 to February 2010 to determine the feasibility and effectiveness of a WTLM intervention for older adults using daily self-monitoring of body weight , step count , fruit/vegetable ( F/V ) intake , and water consumption . Forty weight-reduced individuals ( mean weight lost=6.7±0.6 kg ; body mass index [ calculated as kg/m² ] 29.2±1.1 ) , age 63±1 years , who had previously participated in a 12-week r and omized controlled weight-loss intervention trial , were instructed to record daily body weight , step count , and F/V intake ( WEV [ defined as weight , exercise , and F/V ] ) . Experimental group ( WEV+ ) participants  were also instructed to consume 16 fl oz of water before each main meal ( ie , three times daily ) , and to record daily water intake . Outcome measures included weight change , diet/physical activity behaviors , theoretical 
    Output:
    
Most interventions successfully increased water intake with 13 studies reporting an increase of at least 500 mL. The most effective strategies were  instruction and self-monitoring using urine dipstick or 24 h urine volume .
CONCLUSION All interventions carried out in the studies succeeded in increasing water intake , with none leading to decreases in intake , and these could be implemented in potential clinical trials in CKD .