Evidence map›Paper›PMID 41428040›Full record

Trial reportPediatric nephrology (Berlin, Germany)2026

Increased fluid intake and blood pressure in healthy children: a randomized controlled trial. The SPA Project.

Gianluigi Ardissino, Laura Viola, Maria Cristina Mancuso, Thomas Ria, Giacomo Tamburini, Daniele Rossetti, Letizia Dato, Andrea Gualtieri, Elena Sacchini, Teresa Nittoli and 3 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in Pediatric nephrology (Berlin, Germany), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Blood in urine: an early and constant finding for STEC-HUS diagnosis.Pediatric nephrology (Berlin, Germany) · 2026
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Gianluigi ArdissinoPediatric Nephrology, Dialysis and Transplantation Unit, Centro per la Cura e lo Studio della Sindrome Emolitico-Uremica (Center for HUS Control, Prevention and Management), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. ardissino@centroseu.org.ORCID http://orcid.org/0000-0002-0659-1206
Laura ViolaPediatric Unit, Ospedale di Stato, ISS, San Marino, San Marino.
Maria Cristina MancusoPediatric Nephrology, Dialysis and Transplantation Unit, Centro per la Cura e lo Studio della Sindrome Emolitico-Uremica (Center for HUS Control, Prevention and Management), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Thomas RiaPediatric Nephrology, Dialysis and Transplantation Unit, Centro per la Cura e lo Studio della Sindrome Emolitico-Uremica (Center for HUS Control, Prevention and Management), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Giacomo TamburiniPediatric Nephrology, Dialysis and Transplantation Unit, Centro per la Cura e lo Studio della Sindrome Emolitico-Uremica (Center for HUS Control, Prevention and Management), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Daniele RossettiPediatric Nephrology, Dialysis and Transplantation Unit, Centro per la Cura e lo Studio della Sindrome Emolitico-Uremica (Center for HUS Control, Prevention and Management), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Letizia DatoDivision of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale, Novara, Italy.
Andrea GualtieriPediatric Unit, Ospedale di Stato, ISS, San Marino, San Marino.
Elena SacchiniPediatric Unit, Ospedale di Stato, ISS, San Marino, San Marino.
Teresa NittoliPediatric Nephrology, Dialysis and Transplantation Unit, Centro per la Cura e lo Studio della Sindrome Emolitico-Uremica (Center for HUS Control, Prevention and Management), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Chiara OrsenigoClinical Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Matteo VidaliClinical Pathology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Patrizia SalicePediatric Nephrology, Dialysis and Transplantation Unit, Centro per la Cura e lo Studio della Sindrome Emolitico-Uremica (Center for HUS Control, Prevention and Management), Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundHigh sodium intake is a key element in the development of hypertension, but strategies aimed at reducing its consumption have had limited impact at a population level. A potential alternative preventive and/or therapeutic opportunity may be represented by increasing kidney sodium excretion.

methodsThe Salus per Aquam Project is a multicenter, prospective, controlled, randomized study investigating whether, in healthy children, increased fluid intake for 1 year can lower blood pressure. Participants were randomized into 2 groups: one was actively encouraged to increase their water intake, especially during school days, while the other group was used as a control. At baseline and after 1 year, blood pressure was determined using multiple office blood pressure measurements. Urinary electrolytes and creatinine were measured in multiple samples at baseline, during the study period, and at the end of the study to provide details on sodium and fluid intake.

resultsOne hundred and seventy-five children were enrolled (94 females, 53.7%, median age 8.6 years, IQR:8.4-8.9), but only 145 completed the study. After 12 months, children who were motivated to drink more fluids presented lower median systolic (93 vs. 95 mmHg), diastolic (63 vs. 65 mmHg), and mean (73 vs. 74 mmHg) BP, compared with controls. The median change (ΔMBP, final-baseline) differed significantly between cases and controls, with a between-group median difference of 2 mmHg (Mann-Whitney p = 0.018).

conclusionsAn increased fluid intake may prevent the age-related increase of blood pressure in healthy children. We believe this may be due to more efficient sodium excretion by the kidneys. This simple, highly acceptable, inexpensive, and harmless intervention has the potential to prevent or lessen the prevalence of hypertension and associated illnesses both in adults and children.

Indexed as

Blood PressureDrinkingHypertensionChildFemaleHumansMaleProspective StudiesSodiumSodiumBlood pressureHypertensionPreventionWater intake

Identifiers

PMID41428040
PMCPMC13009042

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.