MO597ESTIMATING INDIVIDUAL-LEVEL SODIUM INTAKE WITH REPEATED SPOT URINE SAMPLING

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Gina Ginos ◽  
Liffert Vogt ◽  
Petra Frings-Meuthen ◽  
Martina Heer ◽  
Rik Olde Engberink
Keyword(s):  
Steady State ◽  
Sodium Intake ◽  
Clinical Settings ◽  
Urine Collection ◽  
Fixed Amount ◽  
Spot Urine ◽  
Individual Level ◽  
Urine Sampling ◽  
Post Hoc

Abstract Background and Aims In daily clinical practice, individual-level sodium (Na) intake is often estimated by measuring Na excretion in a single 24h urine collection, but long-term Na balance studies indicate that 7 consecutive 24h urine collections are needed. However, this approach is not feasible in clinical settings. In this study, we investigate whether the use of repeated spot urine sampling is an appropriate alternative for repeated 24h urine collections. Method We performed a post-hoc analysis of a metabolic ward study in 8 healthy male adults who consumed a 7-day diet with a fixed amount of Na (200 mmol/d). Urine was collected in four daily intervals: 7-13h, 13-19h, 19-23h and 23-7h. After reaching steady state, we estimated Na intake with 1 and 3 consecutive 24h urine collections and 3-day spot urine sampling, using the Kawasaki formula with measured 24h urine creatinine excretion. Results: On day 5, mean 24h Na excretion matched intake, indicating that steady state was achieved (Fig A). Mean and standard deviation of absolute differences between estimated and measured Na intake (ΔNa) for each method were: 18.8 ±14.6 mmol (3 x spot urine 7-13h), 32.3 ±18.7 mmol (3 x spot urine 13-19h), 74.6 ±30.0 mmol (3 x spot urine 19-23h), 28.2 ±19.8 mmol (3 x spot urine 23-7h), 29.8 ±23.9 mmol (1 x 24h urine) and 22.9 ±11.3 mmol (3 x 24h urine) (Fig B). With the exception of the 19-23h spot urine collection period, the accuracy of 3-day spot urine sampling did not significantly differ from accuracy of 1 and 3 consecutive 24h urine collections. When combining the pre-night and morning spot urine collections (19-7h), the accuracy of the estimation did not improve (ΔNa 28.7 ±19.6 mmol). Conclusion 3-day spot urine sampling did not perform significantly different than 1 and 3 24h urine collections for estimation of individual-level Na intake. Adequately powered studies need to confirm whether repeated spot urine sampling is an accurate and low burden alternative to repeated 24h urine collections.

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 Development and double cross-validation of new spot urine sodium equation to predict 24-h urine sodium in the Malaysian population

2021 ◽  
Vol 40 (S1) ◽  
Author(s):  
Fatimah Othman ◽  
Rashidah Ambak ◽  
Mohd Azahadi Omar ◽  
Suzana Shahar ◽  
Noor Safiza Mohd Nor ◽  
...  
Keyword(s):  
Cross Validation ◽  
Sodium Intake ◽  
Study Groups ◽  
Urine Collection ◽  
Urine Sodium ◽  
Data Set ◽  
Spot Urine ◽  
Malaysian Population ◽  
New Equation ◽  
Double Cross

Abstract Background Monitoring sodium intake through 24-h urine collection sample is recommended, but the implementation of this method can be difficult. The objective of this study was to develop and validate an equation using spot urine concentration to predict 24-h sodium excretion in the Malaysian population. Methods This was a Malaysian Community Salt Study (MyCoSS) sub-study, which was conducted from October 2017 to March 2018. Out of 798 participants in the MyCoSS study who completed 24-h urine collection, 768 of them have collected one-time spot urine the following morning. They were randomly assigned into two groups to form separate spot urine equations. The final spot urine equation was derived from the entire data set after confirming the stability of the equation by double cross-validation in both study groups. Newly derived spot urine equation was developed using the coefficients from the multiple linear regression test. A Bland-Altman plot was used to measure the mean bias and limits of agreement between estimated and measured 24-h urine sodium. The estimation of sodium intake using the new equation was compared with other established equations, namely Tanaka and INTERSALT. Results The new equation showed the least mean bias between measured and predicted sodium, − 0.35 (− 72.26, 71.56) mg/day compared to Tanaka, 629.83 (532.19, 727.47) mg/day and INTERSALT, and 360.82 (284.34, 437.29) mg/day. Predicted sodium measured from the new equation showed greater correlation with measured sodium (r = 0.50) compared to Tanaka (r =0.24) and INTERSALT (r = 0.44), P < 0.05. Conclusion Our newly developed equation from spot urine can predict least mean bias of sodium intake among the Malaysian population when 24-h urine sodium collection is not feasible.

scholarly journals Spot urine and 24-h diet recall estimates of dietary sodium intake from the 2008/09 New Zealand Adult Nutrition Survey: a comparison

2020 ◽  
Author(s):  
RM McLean ◽  
SM Williams ◽  
Lisa Te Morenga ◽  
JI Mann
Keyword(s):  
New Zealand ◽  
Sodium Excretion ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Dietary Sodium ◽  
Urine Collection ◽  
Limits Of Agreement ◽  
Nutrition Survey ◽  
Spot Urine ◽  
Diet Recall

© 2018, Macmillan Publishers Limited, part of Springer Nature. Background: We aimed to test the difference between estimates of dietary sodium intake using 24-h diet recall and spot urine collection in a large sample of New Zealand adults. Methods: We analysed spot urine results, 24-h diet recall, dietary habits questionnaire and anthropometry from a representative sample of 3312 adults aged 15 years and older who participated in the 2008/09 New Zealand Adult Nutrition Survey. Estimates of adult population sodium intake were derived from 24-h diet recall and spot urine sodium using a formula derived from analysis of INTERSALT data. Correlations, limits of agreement and mean difference were calculated for the total sample, and for population subgroups. Results: Estimated total population 24-h urinary sodium excretion (mean (95% CI)) from spot urine samples was 3035 mg (2990, 3079); 3612 mg (3549, 3674) for men and 2507 mg (2466, 2548) for women. Estimated mean usual daily sodium intake from 24-h diet recall data (excluding salt added at the table) was 2564 mg (2519, 2608); 2849 mg (2779, 2920) for men and 2304 mg (2258, 2350) for women. Correlations between estimates were poor, especially for men, and limits of agreement using Bland–Altman mean difference analysis were wide. Conclusions: There is a poor agreement between estimates of individual sodium intake from spot urine collection and those from 24-hour diet recall. Although, both 24-hour dietary recall and estimated urinary excretion based on spot urine indicate mean population sodium intake is greater than 2 g, significant differences in mean intake by method deserve further investigation in relation to the gold standard, 24-hour urinary sodium excretion.

scholarly journals Use of a Single Baseline Versus Multiyear 24-Hour Urine Collection for Estimation of Long-Term Sodium Intake and Associated Cardiovascular and Renal Risk

Circulation ◽  
2017 ◽  
Vol 136 (10) ◽  
pp. 917-926 ◽  
Author(s):  
Rik H.G. Olde Engberink ◽  
Thomas C. van den Hoek ◽  
Nicky D. van Noordenne ◽  
Bert-Jan H. van den Born ◽  
Hessel Peters-Sengers ◽  
...  
Keyword(s):  
Sodium Intake ◽  
Urine Collection ◽  
Single Baseline

scholarly journals Spot urine and 24-h diet recall estimates of dietary sodium intake from the 2008/09 New Zealand Adult Nutrition Survey: a comparison

2020 ◽  
Author(s):  
RM McLean ◽  
SM Williams ◽  
Lisa Te Morenga ◽  
JI Mann
Keyword(s):  
New Zealand ◽  
Sodium Excretion ◽  
Sodium Intake ◽  
Urinary Sodium Excretion ◽  
Dietary Sodium ◽  
Urine Collection ◽  
Limits Of Agreement ◽  
Nutrition Survey ◽  
Spot Urine ◽  
Diet Recall

© 2018, Macmillan Publishers Limited, part of Springer Nature. Background: We aimed to test the difference between estimates of dietary sodium intake using 24-h diet recall and spot urine collection in a large sample of New Zealand adults. Methods: We analysed spot urine results, 24-h diet recall, dietary habits questionnaire and anthropometry from a representative sample of 3312 adults aged 15 years and older who participated in the 2008/09 New Zealand Adult Nutrition Survey. Estimates of adult population sodium intake were derived from 24-h diet recall and spot urine sodium using a formula derived from analysis of INTERSALT data. Correlations, limits of agreement and mean difference were calculated for the total sample, and for population subgroups. Results: Estimated total population 24-h urinary sodium excretion (mean (95% CI)) from spot urine samples was 3035 mg (2990, 3079); 3612 mg (3549, 3674) for men and 2507 mg (2466, 2548) for women. Estimated mean usual daily sodium intake from 24-h diet recall data (excluding salt added at the table) was 2564 mg (2519, 2608); 2849 mg (2779, 2920) for men and 2304 mg (2258, 2350) for women. Correlations between estimates were poor, especially for men, and limits of agreement using Bland–Altman mean difference analysis were wide. Conclusions: There is a poor agreement between estimates of individual sodium intake from spot urine collection and those from 24-hour diet recall. Although, both 24-hour dietary recall and estimated urinary excretion based on spot urine indicate mean population sodium intake is greater than 2 g, significant differences in mean intake by method deserve further investigation in relation to the gold standard, 24-hour urinary sodium excretion.

scholarly journals Estimation of sodium consumption by novel formulas derived from random spot and 12-hour urine collection

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0260408
Author(s):  
Pitchaporn Sonuch ◽  
Surasak Kantachuvesiri ◽  
Prin Vathesatogkit ◽  
Raweewan Lappichetpaiboon ◽  
Worawan Chailimpamontri ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Sodium Intake ◽  
Urine Collection ◽  
Cross Sectional Survey ◽  
Urine Sodium ◽  
Thai Population ◽  
Cross Sectional ◽  
Spot Urine ◽  
Urine Sodium Excretion ◽  
Predicted Values

The gold standard for estimating sodium intake is 24h urine sodium excretion. Several equations have been used to estimate 24h urine sodium excretion, however, a validated formula for calculating 24h urine sodium excretion from 12h urine collection has not yet been established. This study aims to develop novel equations for estimating 24h urine sodium excretion from 12h and random spot urine collection and also to validate existing spot urine equations in the Thai population. A cross-sectional survey was carried out among 209 adult hospital personnel. Participants were asked to perform a 12h daytime, 12h nighttime, and a random spot urine collection over a period of 24 hours. The mean 24h urine sodium excretion was 4,055±1,712 mg/day. Estimated urine sodium excretion from 3 different equations using random spot urine collection showed moderate correlation and agreement with actual 24h urine sodium excretion (r = 0.54, P<0.001, ICC = 0.53 for Kawasaki; r = 0.57, P<0.001, ICC = 0.44 for Tanaka; r = 0.60, P<0.001, ICC = 0.45 for INTERSALT). Novel equations for predicting 24h urine sodium excretion were then developed using variables derived from 12h daytime urine collection, 12h nighttime urine collection, random spot urine collection, 12h daytime with random spot urine collection, and 12h nighttime with random spot urine collection which showed strong correlation and agreement with actual measured values (r = 0.88, P<0.001, ICC = 0.87; r = 0.83, P<0.001, ICC = 0.81; r = 0.67, P<0.001, ICC = 0.62; r = 0.90, P<0.001, ICC = 0.90; and r = 0.83, p<0.001, ICC = 0.82 respectively). Bland-Altman plots indicated good agreement between predicted values and actual 24h urine sodium excretion using the new equations. Newly derived equations from 12h daytime and 12h nighttime urine collection with or without casual spot urine collection were able to accurately predict 24h urine sodium excretion.

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).

Evaluation of the spot urine sampling technique to assess urinary purine derivative excretion in lactating dairy cows

1998 ◽  
Vol 66 (3) ◽  
pp. 557-568 ◽  
Author(s):  
K. J. Shingfield ◽  
N. W. Offer
Keyword(s):  
Dairy Cows ◽  
Sampling Technique ◽  
Experimental Period ◽  
Molar Ratio ◽  
Prediction Errors ◽  
Urine Collection ◽  
Purine Derivative ◽  
Spot Urine ◽  
Urine Sampling ◽  
Total Urine

AbstractThe potential of the spot urine sampling technique as an alternative to performing a total urine collection was evaluated. Twelve multiparous Holstein-Friesian cows were given two experimental diets in a complete change-over design using two 14-day experimental periods. Experimental diets were either silage offeredad libitumwith 7 kg fresh weight concentrate supplement as a single meal (SF), or a complete diet formulated from the same ingredients with a similar foragexoncentrate ratio (CD). Total urine collections were performed every 2 h on days 11 and 14 of each experimental period. Subsamples of urine were stored at 20°C and subsequently analysed by high-performace liquid chromatography. Daily allantoin and purine derivative (PD) excretion were highly correlated (r = 0·995, no. = 48,P< 0·001). PD and creatinine excretion during each 2-h interval depended on time of collection (PD,P< 0·001 and creatinine,P< 0·05) and on cow (P< 0·01) but were unaffected by sampling day or treatment. Diurnal variations in the molar ratio ofPD or allantoin to creatinine (PD/c and Ale, respectively) followed similar diurnal patterns as observed for PD and allantoin excretion. The data were used to assess the error of prediction of daily mean PD/c or Ale ratios. Three spot sampling regimens (based on the collection of four 4-h samples, three 8-h samples or two 12-h samples) and also on either single or 2-day urine collections were evaluated. Collection of multiple samples within a day was more reliable than collecting fewer samples over several days. Prediction errors were greater for SF compared with CD. Even the most intensive sampling regimen did not allow an acceptable prediction of daily mean PDIc or Ale ratio, minimum r values for PDIc and Ale ratios were 0·098, 0·136 and 0·547, 0·579 for SF and CD, respectively. Furthermore, daily mean PDIc and Ale ratios proved poor predictors of daily PD and allantoin excretion (r values of 0·69 and 0·72, respectively). Total urine collection appears necessary to assess accurately daily PD excretion in dairy cows.

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.

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