Multiple, random spot urine sampling for estimating urinary sodium excretion

2021 ◽  
Author(s):  
Gianluigi Ardissino ◽  
Antonio Vergori ◽  
Cesare Vergori ◽  
Laura Martelli ◽  
Valeria Daccò ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium ◽  
Spot Urine ◽  
Urine Sampling

scholarly journals 24-Hour vs. Spot Urinary Sodium and Potassium Measurements in Adult Hypertensive Patients: A Cohort Validation Study

2019 ◽  
Vol 32 (10) ◽  
pp. 983-991
Author(s):  
Elizabeth R Wan ◽  
Jennifer Cross ◽  
Reecha Sofat ◽  
Stephen B Walsh
Keyword(s):  
Sodium Excretion ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Sodium Concentration ◽  
Serum Biochemistry ◽  
Urinary Sodium ◽  
Hypertensive Patients ◽  
Spot Urine ◽  
Sodium Ingestion ◽  
Weak Negative Correlation

Abstract BACKGROUND Sodium intake is correlated with the development of hypertension. Guyton’s principals suggest that the 24-hour urinary sodium excretion reflects sodium ingestion over the same period. 24-hour urine collections are arduous to collect, so many centers use spot urinary measurements instead. We compared spot to matched 24-hour urinary electrolyte measurements. METHODS We examined 419 hypertensive patients from the UCL Complex Hypertension Clinic. 77 had matched and complete 24-hour and spot urinary and serum biochemistry to examine. We compared the spot and 24-hour urinary; sodium concentration, Na/Cr ratio, FENa, Kawasaki and Tanaka estimated sodium excretion as well as the potassium concentration, K/Cr ratio, Kawasaki and Tanaka potassium excretion. RESULTS Our cohort was 58% male and the median age was 41 years. The 24-hour and spot Na concentrations correlated moderately (r = 0.4633, P < 0.0001). The 24-hour and spot Na/creatinine ratios correlated weakly (r = 0.2625, P = 0.0194). The 24-hour and spot FENa results showed a weak negative correlation (r = −0.222, P = ns). The 24-hour sodium excretion and the Kawasaki-derived spot urine sodium excretion correlated moderately (r = 0.3118, P = 0.0052). All Bland–Altman analyses showed poor agreement. The 24-hour and spot potassium concentrations correlated very poorly (r = 0.1158, P = ns). The 24-hour and spot urinary K/creatinine ratios correlated weakly (r = 0.47, P ≤ 0.0001). 24-hour and Kawasaki and Tanaka estimated potassium excretions correlated much better (r = 0.58, P < 0.0001). CONCLUSIONS Spot urinary measurements of sodium give a very poor understanding of the natriuresis occurring over the same 24-hour period. The Kawasaki and Tanaka estimations of the 24-hour sodium excretion showed a much lower correlation than previously reported.

scholarly journals Spot Urine Formulas to Estimate 24-Hour Urinary Sodium Excretion Alter the Dietary Sodium and Blood Pressure Relationship

Hypertension ◽  
2021 ◽  
Author(s):  
Abu Mohd Naser ◽  
Feng J. He ◽  
Mahbubur Rahman ◽  
Norm R.C. Campbell
Keyword(s):  
Blood Pressure ◽  
Sodium Excretion ◽  
Linear Models ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium ◽  
Dietary Sodium ◽  
Urine Sodium ◽  
Spot Urine ◽  
Urine Sodium Excretion ◽  
The Relationship

We evaluated the relationship between estimated 24-hour urinary sodium excretion from the Kawasaki, Tanaka, and INTERSALT (International Study of Sodium, Potassium, and Blood Pressure) formulas and blood pressure (BP). We pooled 10 034 person-visit data from 3 cohort studies in Bangladesh that had measured 24-hour urine sodium (m-24hUNa), potassium, creatinine excretion, and BP. We used m-24hUNa, potassium, and creatinine where necessary, rather than spot urine values in the formulas. Bland-Altman plots were used to determine the bias associated with formula-estimated sodium relative to m-24hUNa. We compared the sodium excretion and BP relationships from m-24hUNa versus formula-estimated sodium excretions, using restricted cubic spline plots for adjusted multilevel linear models. All formulas overestimated 24-hour sodium at lower levels but underestimated 24-hour sodium at higher levels. There was a linear relationship between m-24hUNa excretion and systolic BP, while estimated sodium excretion from all 3 formulas had a J-shaped relationship with systolic BP. The relationships between urine sodium excretion and diastolic BP were more complex but were also altered by using formulas. All formulas had associations with BP when a sex-specific constant sodium concentration was inserted in place of measured sodium. Since we used the m-24hUNa, potassium, and creatinine concentrations in formulas, the J-shaped relationships are due to intrinsic problems in the formulas, not due to spot urine sampling. Formula-estimated 24-hour urine sodium excretion should not be used to examine the relationship between sodium excretion and BP since they alter the real associations.

Abstract P362: Validation of a Simple Method to Estimate Populational 24-h Urinary Sodium Excretion Based on a Casual Urine Specimen in an Adult Danish Population

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Ulla Toft ◽  
Charlotte Cerquira ◽  
Torben Jørgensen
Keyword(s):  
Sodium Excretion ◽  
Sodium Intake ◽  
Prediction Method ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium ◽  
Urine Specimen ◽  
Urine Collection ◽  
Danish Population ◽  
Simple Method ◽  
Spot Urine

Background: Tanaka et al (J Hum Hypert 2002; 16: 97-103) developed a simple method to estimate populational 24-h urinary sodium excretion using a casual urine specimen. However, this method was developed and validated in a Japanese population and thus this method might not be valid in populations that differ markedly from this population. Hypothesis: We assessed the hypothesis that the 24 hour urinary sodium excretion can be estimated from a casual spot urine using the Tanaka prediction method in a Danish general population. Methods: Overall 473 Danish individuals provided both a 24h urine collection and a spot urine sample. Data were collected in the Danthyr study (248 women aged 25-30 years and 60-65 years) and the Inter99 study (102 men and 113 women aged 30-60 years), respectively. Only participants with complete 24h urine collection (validated by the PABA method) were included. We compared the estimated daily sodium excretion through 24h urine (the gold standard) with the predicted 24 h sodium excretion from a causal urine specimen, using the Tanaka prediction method. Results: The predicted median 24 h sodium excretion (median [5 and 95 percentile]) was 8.6 gram [3.7;17.5] compared with a median measured 24 h sodium excretion of 8.9 [5.4; 13:1]. The mean (sd) residual (measured minus predicted 24 h sodium excretion) was 0.08 (3.7). The correlation (Spearman) between predicted and measured 24 h sodium excretion was 0.39 and the R 2 was 0.17. The proportion of individuals classified in the same or adjacent quintiles was 67%. Gross misclassification was found for 3% of the individuals. However, a Bland-Altman plot indicated a tendency of underestimation the sodium excretion for individuals with a high level of sodium excretion (>14 g per day). Conclusion: The Tanaka prediction model gives a reasonable estimate of sodium intake in a Danish population using casual spot urines. However, the validation study showed a tendency of underestimation of the sodium intake for individuals with a high sodium excretion (>14 g per day).

scholarly journals Estimation of 24-Hour Urinary Sodium Excretion Using Spot Urine Samples

Nutrients ◽  
2014 ◽  
Vol 6 (6) ◽  
pp. 2360-2375 ◽  
Author(s):  
Moo-Yong Rhee ◽  
Ji-Hyun Kim ◽  
Sung-Joon Shin ◽  
Namyi Gu ◽  
Deuk-Young Nah ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium ◽  
Urine Samples ◽  
Spot Urine

scholarly journals Prediction of 24-Hour Urinary Sodium Excretion Using a Single Spot Urine Samples in Moroccan Population

2021 ◽  
Vol 319 ◽  
pp. 01066
Author(s):  
Mohamed Idrissi ◽  
Naima Saeid ◽  
Anass Rami ◽  
Mohammed El Mzibri ◽  
Arthur Assako ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Urinary Sodium ◽  
Urine Collection ◽  
Validation Data ◽  
Data Set ◽  
Single Spot ◽  
Spot Urine ◽  
Moroccan Population

Background: Excessive sodium intake is linked to high blood pressure. Estimating sodium intake is difficult. The 24-h urine collection is currently the recommended method for estimating intake but cumbersome for large population studies. Predictive model to estimate sodium intake based on single spot urine were developed, but showed inconsistency when used in extern populations. This study aims to develop a specific model for estimating sodium excretion over 24 hours for the Moroccan population. Methods: 371 participants in the urinary validation sub-study of the STEP-wise survey-Morocco 2017-2018 provided a valid 24-hour urine collection and spot urine specimens. Participant were randomly assigned to the training (n=183) and the validation data set (n=188). Results: A prediction model for 24-hour sodium excretion was developed. Adjusted R2 was 0.258. In the validation data set, correlation was 0.431 [95%CI; 0.258-0.580], and the adjusted R2 was 0.190. The Bland-Altman plot showed a nonsignificant small mean bias of -18 mg (95%CI, -213 to 177) in predicting 24-h urinary sodium excretion at the group level. At the individual level, limits of agreement were wide. Conclusion: This new model developed from a single spot urine could be used to predict the average 24-h sodium excretion of Moroccan adults.

scholarly journals Effects of a Novel Contextual Just-In-Time Mobile App Intervention (LowSalt4Life) on Sodium Intake in Adults With Hypertension: Pilot Randomized Controlled Trial

10.2196/16696 ◽  
2020 ◽  
Vol 8 (8) ◽  
pp. e16696
Author(s):  
Michael P Dorsch ◽  
Maria L Cornellier ◽  
Armella D Poggi ◽  
Feriha Bilgen ◽  
Peiyu Chen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sodium Excretion ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Mobile App ◽  
Urinary Sodium ◽  
Just In Time ◽  
Spot Urine ◽  
Low Sodium Diet ◽  
Low Sodium

Background High dietary sodium intake is a significant public health problem in the United States. High sodium consumption is associated with high blood pressure and high risk of cardiovascular disease. Objective The aim of this study was to evaluate the effect of a just-in-time adaptive mobile app intervention, namely, LowSalt4Life, on reducing sodium intake in adults with hypertension. Methods In this study, 50 participants aged ≥18 years who were under treatment for hypertension were randomized (1:1, stratified by gender) into 2 groups, namely, the App group (LowSalt4Life intervention) and the No App group (usual dietary advice) in a single-center, prospective, open-label randomized controlled trial for 8 weeks. The primary endpoint was the change in the 24-hour urinary sodium excretion estimated from spot urine by using the Kawasaki equation, which was analyzed using unpaired two-sided t tests. Secondary outcomes included the change in the sodium intake measured by the food frequency questionnaire (FFQ), the 24-hour urinary sodium excretion, blood pressure levels, and the self-reported confidence in following a low-sodium diet. Results From baseline to week 8, there was a significant reduction in the Kawasaki-estimated 24-hour urinary sodium excretion calculated from spot urine in the App group compared to that in the No App group (–462 [SD 1220] mg vs 381 [SD 1460] mg, respectively; P=.03). The change in the 24-hour urinary sodium excretion was –637 (SD 1524) mg in the App group and –322 (SD 1485) mg in the No App group (P=.47). The changes in the estimated sodium intake as measured by 24-hour dietary recall and by FFQ in the App group were –1537 (SD 2693) mg and –1553 (SD 1764) mg while those in the No App group were –233 (SD 2150) mg and –515 (SD 1081) mg, respectively (P=.07 and P=.01, respectively). The systolic blood pressure change from baseline to week 8 in the App group was –7.5 mmHg while that in the No App group was –0.7 mmHg (P=.12), but the self-confidence in following a low-sodium diet was not significantly different between the 2 groups. Conclusions This study shows that a contextual just-in-time mobile app intervention resulted in a greater reduction in the dietary sodium intake in adults with hypertension than that in the control group over a 8-week period, as measured by the estimated 24-hour urinary sodium excretion from spot urine and FFQ. The intervention group did not show a significant difference from the control group in the self-confidence in following a low sodium diet and in the 24-hour urinary sodium excretion or dietary intake of sodium as measured by the 24-hour dietary recall. A larger clinical trial is warranted to further elucidate the effects of the LowSalt4Life intervention on sodium intake and blood pressure levels in adults with hypertension. Trial Registration ClinicalTrials.gov NCT03099343; https://clinicaltrials.gov/ct2/show/NCT03099343 International Registered Report Identifier (IRRID) RR2-10.2196/11282

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