Accuracy of equations for predicting 24-h urinary potassium excretion from spot urine samples in Chinese children

2021 ◽  
pp. 1-9
Author(s):  
Xiaolu Nie ◽  
Yaguang Peng ◽  
Siyu Cai ◽  
Zehao Wu ◽  
Ying Zhang ◽  
...  
Keyword(s):  
Urine Samples ◽  
Misclassification Rate ◽  
Accurate Estimation ◽  
Potassium Excretion ◽  
Spot Urine ◽  
Individual Level ◽  
Potassium Intake ◽  
Urinary Potassium ◽  
The Mean ◽  
The Individual

Abstract Accurate assessments of potassium intake in children are important for the early prevention of CVD. Currently, there is no simple approach for accurate estimation of potassium intake in children. We aim to evaluate the accuracy of 24-h urinary potassium excretion (24UKV) estimation in children using three common equations: the Kawasaki, Tanaka and Mage formulas, in a hospital-based setting. A total of 151 participants aged 5–18 years were initially enrolled, and spot urine samples were collected in the whole 24-h duration to measure the concentrations of potassium and creatinine. We calculated the mean difference, absolute and relative difference and misclassification rate between measured 24UKV and the predicted ones using Kawasaki, Tanaka and Mage formulas in 129 participants. The mean measured 24UKV was 1193·3 mg/d in our study. Mean differences between estimated and measured 24UKV were 1215·6, −14·9 and 230·3 mg/d by the Kawasaki, Tanaka and Mage formulas, respectively. All estimated 24UKV were significantly different from the measured values in all the time point (all P < 0·05), except for the predicted values from Tanaka formula using morning, afternoon and evening spot urine. The proportions with relative differences over 40 % were 87·2%, 32·5% and 47·3 % for Kawasaki, Tanaka and Mage formulas, respectively. Misclassification rates were 91·5 % for Kawasaki, 44·4 % for Tanaka and 58·9 % for Mage formula at the individual level. Our findings showed that misclassification could occur on the individual level when using Kawasaki, Tanaka and Mage formulas to estimate 24UKV from spot urine in the child population.

scholarly journals Estimating 24-Hour Sodium Excretion from Spot Urine Samples in Chinese Adults: Can Spot Urine Substitute 24-Hour Urine Samples?

Nutrients ◽  
2020 ◽  
Vol 12 (3) ◽  
pp. 798
Author(s):  
Jianwei Xu ◽  
Jiyu Zhang ◽  
Min Liu ◽  
Yamin Bai ◽  
Xiaolei Guo ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Population Level ◽  
Relative Difference ◽  
Urine Samples ◽  
Misclassification Rate ◽  
Absolute Difference ◽  
Sample Collection ◽  
Spot Urine ◽  
Individual Level ◽  
Chinese Populations

Several estimating equations for predicting 24-h urinary sodium (24-hUNa) excretion using spot urine (SU) samples have been developed, but have not been readily available to Chinese populations. We aimed to compare and validate the six existing methods at population level and individual level. We extracted 1671 adults eligible for both 24-h urine and SU sample collection. Mean biases (95% CI) of predicting 24-hUNa excretion using six formulas were 58.6 (54.7, 62.5) mmol for Kawasaki, −2.7 (−6.2, 0.9) mmol for Tanaka, −24.5 (−28.0, −21.0) mmol for the International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT) with potassium, –26.8 (−30.1, −23.3) mmol for INTERSALT without potassium, 5.9 (2.3, 9.6) mmol for Toft, and −24.2 (−27.7, −20.6) mmol for Whitton. The proportions of relative difference >40% with the six methods were nearly a third, and the proportions of absolute difference >51.3 mmol/24-h (3 g/day salt) were more than 40%. The misclassification rate were all >55% for the six methods at the individual level. Although the Tanaka method could offer a plausible estimation for surveillance of the population sodium excretion in Shandong province, caution remains when using the Tanaka formula for other provincial populations in China. However, these predictive methods were inadequate to evaluate individual sodium excretion.

Estimated 24 Hour Urinary Sodium and Potassium Excretion in a Population of Moroccan Adults

2021 ◽  
Author(s):  
Mohamed idrissi ◽  
Naima Saeid ◽  
Samir Mounach ◽  
Hicham El Berri ◽  
Ayoub Al Jawaldah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sodium Excretion ◽  
Sodium Intake ◽  
Eastern Mediterranean Region ◽  
Urinary Sodium ◽  
World Health ◽  
Potassium Excretion ◽  
Potassium Intake ◽  
Urinary Potassium ◽  
The Mean

Abstract Background: Excessive sodium (Na) intake and low potassium (K) intake are associated with adverse cardiovascular health outcomes. Morocco lacks data on actual Na and K intake in adults. The aim of this study was to estimate the mean intake of Na and K in a Moroccan population of adults using the 24-h urinary excretion and to examine their association with blood pressure (BP). Methods: A total of 371 adults, who participated in the urinary validation sub-study of the STEP-wise Survey-Morocco-2017-2018, have complete data on demographic, anthropometric and blood pressure and have provided a valid 24-h urine collection according to the standard protocol of the World Health Organization (WHO). Results: The mean 24-h urinary sodium excretion was 2794 mg (SD, 1394) and the median was 2550 mg (IQR, 1780-3726). The mean 24-h urinary potassium excretion was 1898 mg (SD, 1044) and the median was 1640 mg (IQR, 1170-2410). Sodium excretion was between 3000 and 5000 mg/day in 31% of participants, < 3000 mg/day in 64%, and > 5000 mg/day in only 5%. No significant association of urinary sodium or potassium with blood pressure was found. Conclusion: Sodium intake in the studied population of Moroccan adults was higher than WHO recommendation and was comparable to levels reported in countries from Eastern Mediterranean Region. The vast majority of participants had a sodium intake < 5000 mg/day, with only 5% were above this level. Potassium intake was in the range of 1000 to 3000 mg/day. Within these ranges, there was no association between sodium or potassium intake and blood pressure. This information is crucial to help implement the national strategy to reduce sodium intake as a cost-effective intervention to prevent chronic disease in Morocco.

scholarly journals Validity of predictive equations for 24-h urinary potassium excretion based on timing of spot urine collection among adults: the MESA and CARDIA Urinary Sodium Study and NHANES Urinary Sodium Calibration Study

2018 ◽  
Vol 108 (3) ◽  
pp. 532-547 ◽  
Author(s):  
Carla I Mercado ◽  
Mary E Cogswell ◽  
Catherine M Loria ◽  
Kiang Liu ◽  
Norrina Allen ◽  
...  
Keyword(s):  
Prediction Equation ◽  
Cross Sectional Study ◽  
Urinary Sodium ◽  
Urine Samples ◽  
Potassium Excretion ◽  
Urine Collection ◽  
Cross Sectional ◽  
Spot Urine ◽  
Study Results ◽  
Urinary Potassium

ABSTRACT Background 24-h urine collections are the suggested method to measure daily urinary potassium excretion (uK) but are costly and burdensome to implement. Objective This study tested how well existing equations with the use of spot urine samples can estimate 24-h uK and if accuracy varies by timing of spot urine collection, age, race, or sex. Design This cross-sectional study used data from 407 participants aged 18–39 y from the Washington, DC area in 2011 and 554 participants aged 45–79 y from Chicago in 2013. Spot urine samples were collected in individual containers for 24 h, and 1 for each timed period (morning, afternoon, evening, and overnight) was selected. For each selected timed spot urine, 24-h uK was predicted through the use of published equations. Difference (bias) between predicted and measured 24-h uK was calculated for each timed period and within age, race, and sex subgroups. Individual-level differences were assessed through the use of Bland-Altman plots and correlation tests. Results For all equations, regardless of the timing of spot urine, mean bias was usually significantly different than 0. No one prediction equation was unbiased across all sex, race, and age subgroups. With the use of the Kawasaki and Tanaka equations, 24-h uK was overestimated at low levels and underestimated at high levels, whereas observed differential bias with the Mage equation was in the opposite direction. Depending on prediction equation and timing of urine sample, 61–75% of individual 24-h uKs were misclassified among 500-mg incremental categories from <1500 to ≥3000 mg. Correlations between predicted and measured 24-h uK were poor to moderate (0.19–0.71). Conclusion Because predicted 24-h uK accuracy varies by timing of spot urine collection, published prediction equations, and within age-race-sex subgroups, study results making use of predicted 24-h uK in association with health outcomes should be interpreted with caution. It is possible that a more accurate prediction equation can be developed leading to different results.

scholarly journals Low potassium intake and its association with blood pressure among adults in Malaysia: findings from the MyCoSS (Malaysian Community Salt Survey)

2021 ◽  
Vol 40 (S1) ◽  
Author(s):  
Lalitha Palaniveloo ◽  
Rashidah Ambak ◽  
Fatimah Othman ◽  
Nor Azian Mohd Zaki ◽  
Azli Baharudin ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Rural Areas ◽  
Adult Population ◽  
Further Education ◽  
Cluster Sampling ◽  
Potassium Excretion ◽  
Daily Consumption ◽  
Blood Pressure Monitor ◽  
Potassium Intake ◽  
Urinary Potassium

Abstract Background High blood pressure or hypertension is well recognized as an important modifiable risk factor for cardiovascular diseases. Several studies had indicated potassium intake has a blood pressure lowering effect. This study aimed to estimate potassium intake via 24-h urinary potassium excretion and to determine the association between potassium intake and blood pressure among adults in Malaysia. Methods Data for 424 respondents in this study were drawn from MyCoSS, a nationwide cross- sectional study conducted among Malaysians who were 18 years and above. Respondents were recruited using stratified cluster sampling, covering urban and rural areas in each state in Malaysia. Data collection was undertaken from October 2017 until March 2018. A single urine sample was collected over 24 h for quantification of potassium excreted. Information on socio-demography and medical history of the respondents were collected by interviewer-administered questionnaires. Anthropometric measurements were measured using validated equipment. BMI was estimated using measured body weight and height. Digital blood pressure monitor (Omron HBP-1300) was used to measure blood pressure. Descriptive statistics, analysis of variance (ANOVA), and multivariable linear regression were used to analyze the data in SPSS Version 21. Results Mean 24-h urinary potassium excretion for the 424 respondents was 37 mmol (95% CI 36, 38). Gender and ethnicity showed statistically significant associations with 24-h urinary potassium excretion. However, potassium excretion was not significantly associated with blood pressure in this study. Conclusion Potassium intake is very low among the adults in Malaysia. Therefore, further education and promotional campaigns regarding daily consumption of potassium-rich diet and its benefits to health need to be tailored for the Malaysian adult population.

Abstract MP78: Validity of Predictive Equations for 24-Hour Urine Sodium Excretion in Young Black and Other Adults

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Mary Cogswell ◽  
Chia-Yih Wang ◽  
Te-Ching Chen ◽  
Christine Pfeiffer ◽  
Paul Elliott ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Sodium Intake ◽  
Urine Collection ◽  
Urine Sodium ◽  
Predictive Equations ◽  
Spot Urine ◽  
Individual Level ◽  
Urine Sodium Excretion ◽  
Mean Differences ◽  
The Individual

Introduction: Reducing mean population sodium intake by ~1200 mg is projected to reduce thousands of deaths from heart disease and stroke and save billions of health care dollars annually. Twenty-four hour urine collection is recommended for assessing changes in mean population sodium intake, but can be difficult to implement. Predicting 24-hour urine sodium excretion using spot urines is not recommended due to diurnal variations in excretion. Further, sodium excretion patterns differ between black and white persons. We assessed the validity of previously published prediction equations for 24-hour sodium excretion in black and other young adults by timing of spot urine collection. Design: Of 481 adult volunteers aged 18-39 years (50% Blacks) asked to participate in a 2011 study in the Metropolitan DC area, 407 collected each urine void in a separate container for 24 hours. Four timed voids from the 24-h urine collection were selected (morning, afternoon, evening, and overnight) to use with previously published predictive equations. Predictive equations were based on one of two approaches; 1) an indirect approach using spot urine sodium-to-creatinine concentrations and predicted 24-hour creatinine excretion ( Tanaka, Kawasaki, Mage ), and 2) a direct approach using spot urine sodium, potassium, and creatinine concentrations, and age, and body mass index with separate equations by sex ( Brown ). We assessed mean differences between predicted and measured 24-hour sodium excretion (bias) and individual differences across levels of sodium excretion using Bland-Altman plots. Results: Among participants, mean measured 24-hour sodium excretion was ~3300 mg (SD ~1400 mg). Of the equations evaluated, mean bias in predicted 24-hour sodium excretion was least from Brown equations when using morning (-165 mg, 95% confidence interval [CI], -295, -36 mg), afternoon (-90 mg, 95% CI, -208, 28 mg) or evening ( -120 mg, 95% CI -230, -11 mg) spot urines. When using overnight spot urines, mean bias from Brown equations was greatest and statistically significant (-247 mg, 95% CI, -348, -151 mg). When using overnight spot urines, mean bias from Tanaka (-23 mg) or Mage (-145 mg) equations was not significant, however, when stratified by sex, mean biases were significant and in opposite directions. Among Blacks, mean biases from Brown were not significant (-167 to 122 mg) except using overnight specimens among Black females (-267 mg, 95% CI, -525, -47 mg). Across equations and time periods, Bland-Altman plots indicated significant bias at the individual level. Conclusions: Of the evaluated equations, predicted 24-hour urine sodium excretion using the Brown equations with morning, afternoon, or evening specimens may provide the least biased estimates of group mean sodium intake among young US adults. None of the equations adequately predicted individual 24-hour sodium excretion measured on the same day.

scholarly journals Revised Reference Values for Potassium Intake

2017 ◽  
Vol 71 (1-2) ◽  
pp. 118-124 ◽  
Author(s):  
Daniela Strohm ◽  
Sabine Ellinger ◽  
Eva Leschik-Bonnet ◽  
Friederike Maretzke ◽  
Helmut Heseker ◽  
...  
Keyword(s):  
Breast Milk ◽  
Children And Adolescents ◽  
Reference Values ◽  
Health Benefit ◽  
Reference Value ◽  
Potassium Excretion ◽  
Lactating Women ◽  
Potassium Intake ◽  
Breastfed Infants ◽  
Urinary Potassium

Background: The nutrition societies of Germany, Austria and Switzerland have revised the reference values for potassium intake in January 2017. Methods: For adults, the estimated value was based on the 24-h urinary potassium excretion and on preventive considerations regarding hypertension and stroke. The estimated values for children and adolescents were extrapolated from the adult estimated value considering differences in body mass. For infants aged 0 to under 4 months, the estimated value was set based on the potassium intake via breast milk. From this reference value, the estimated value for infants aged 4 to under 12 months was also derived by extrapolation. The estimated value for lactating women takes into account the potassium loss via breast milk. Results: The estimated values for potassium intake are set at 400 mg/day for breastfed infants aged 0 to under 4 months, 600 mg/day for infants aged 4 to under 12 months, 1,100-4,000 mg/day for children and adolescents, 4,000 mg/day for adults and pregnant women and 4,400 mg/day for lactating women. Conclusions: The consumption of potassium-rich foods should be generally increased. Supplemental intake beyond the estimated values has no health benefit and is therefore not recommended.

Changes in wild red squirrel personality across ontogeny: activity and aggression regress towards the mean

Behaviour ◽  
2015 ◽  
Vol 152 (10) ◽  
pp. 1291-1306 ◽  
Author(s):  
A.D. Kelley ◽  
M.M. Humphries ◽  
A.G. McAdam ◽  
Stan Boutin
Keyword(s):  
Structural Stability ◽  
Environmental Changes ◽  
Population Level ◽  
Behavioural Syndrome ◽  
Red Squirrels ◽  
Individual Level ◽  
Personality Changes ◽  
The Mean ◽  
Differential Stability ◽  
The Individual

Both juvenile and adult animals display stable behavioural differences (personality), but lifestyles and niches may change as animals mature, raising the question of whether personality changes across ontogeny. Here, we use a wild population of red squirrels to examine changes in activity and aggression from juvenile to yearling life stages. Personality may change at the individual level (individual stability), population level (mean level stability), and relative to other individuals (differential stability). We calculated all three types of stability, as well as the structural stability of the activity–aggression behavioural syndrome. Within individuals, both activity and aggression scores regressed towards the mean. Differential stability was maintained for activity, but not aggression. Structural stability was maintained; however, the activity–aggression correlation increased in squirrels that gained territories later in the season. These results suggest that personality undergoes some changes as animals mature, and that the ontogeny of personality can be linked to environmental changes.

Interrelated effects of aldosterone and plasma potassium on potassium excretion

1983 ◽  
Vol 244 (1) ◽  
pp. F28-F34 ◽  
Author(s):  
D. B. Young ◽  
A. W. Paulsen
Keyword(s):  
Renal Function ◽  
Potassium Concentration ◽  
Plasma Potassium ◽  
Potassium Excretion ◽  
Normal Range ◽  
Potassium Intake ◽  
Group I ◽  
Urinary Potassium ◽  
The Relationship ◽  
Renal Potassium Excretion

The interacting effects of aldosterone and plasma potassium concentration on steady-state renal potassium excretion were studied in two groups of chronically adrenalectomized dogs. In group I (six dogs, 22.9 kg) aldosterone was infused intravenously at 20 micrograms/day while potassium intake was changed in steps of 7-10 days duration from 10 to 30 to 100 meq/day. At the completion of each step, plasma potassium concentration, urinary potassium excretion, and other variables that potentially may affect renal function were measured. In group II (six dogs, 22.2 kg) a similar protocol was followed except that aldosterone was infused at 250 micrograms/day and the potassium intake levels were 30, 100, and 200 meq/day. Plasma potassium concentration and excretion data for the 20 micrograms/day group were: 3.22 +/- 0.26 meq/liter and 5 +/- 1 meq/day, 4.35 +/- 0.08 meq/liter and 21 +/- 2 meq/day, and 5.88 meq/liter and 82 +/- 3 meq/day at the 10, 30, and 100 meq/day intake levels, respectively. For the 250 micrograms/day group the values were: 2.72 +/- 0.18 meq/liter and 28 +/- 7 meq/day, 4.16 +/- 0.14 meq/liter and 71 +/- 8 meq/day, and 4.40 +/- 0.14 meq/liter and 172 +/- 26 meq/day at the 30, 100, and 200 meq/day intake levels. Therefore, the increase in aldosterone infusion rate shifted the relationship between plasma potassium concentration and potassium excretion to the left so that at a given level of plasma potassium a greater amount of potassium was excreted. In the normal range of plasma potassium concentration (4.00-4.40 meq/liter) the increase in aldosterone levels resulted in a four- to eightfold increase in daily potassium excretion.

COMPARING COMMUNITY-PREFERENCE–BASED AND DIRECT STANDARD GAMBLE UTILITY SCORES: EVIDENCE FROM ELECTIVE TOTAL HIP ARTHROPLASTY

2003 ◽  
Vol 19 (2) ◽  
pp. 362-372 ◽  
Author(s):  
David Feeny ◽  
Christopher Blanchard ◽  
Jeffrey L. Mahon ◽  
Robert Bourne ◽  
Cecil Rorabeck ◽  
...  
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Standard Gamble ◽  
Intraclass Correlation ◽  
Individual Level ◽  
Total Hip ◽  
The Mean ◽  
The Individual ◽  
Community Preferences ◽  
Utility Scores

Objectives: Do utility scores based on patient preferences and scores based on community preferences agree? The purpose is to assess agreement between directly measured standard gamble (SG) utility scores and utility scores from the Health Utilities Index Mark 2 (HUI2) and Mark 3 (HUI3) systems.Methods: Patients were assessed repeatedly throughout the process of waiting to see a surgeon, waiting for surgery, and recovery after total hip arthroplasty (THA). Group mean scores are compared using paired t-tests. Agreement is assessed using the intraclass correlation coefficient (ICC).Results: The mean SG, HUI2, and HUI3 (SD) scores at assessment 1 are 0.62 (0.31), 0.62 (0.19), and 0.52 (0.21); n=103. At assessment 2, the means are 0.67 (0.30), 0.68 (0.30), and 0.58 (0.22); n=84. There are no statistically significant differences between group mean SG and HUI2 scores. Mean SG and HUI3 scores are significantly different. ICCs are low.Conclusions: At the mean level for the group, SG and HUI2 scores match closely. At the individual level, agreement is poor. HUI2 scores were greater than HUI3 scores. HUI2 and HUI3 are appropriate for group level analyses relying on community preferences but are not a good substitute for directly measured utility scores at the individual leve.

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