Abstract MP16: The Validity of Predictive Equations for 24-Hour Urine Sodium Excretion Among Older Adults and Those with Hypertension: The MESA and CARDIA Urinary Sodium Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Norrina B Allen ◽  
Lihui Zhao ◽  
Catherine Loria ◽  
Linda Van Horn ◽  
Chia-Yih Wang ◽  
...  
Keyword(s):  
Older Adults ◽  
Black Women ◽  
Urine Sample ◽  
White Women ◽  
Population Distribution ◽  
Urinary Sodium ◽  
Dietary Sodium ◽  
Spot Urine ◽  
Spot Urine Sample ◽  
The Mean

Background: Excess dietary sodium (Na) intake is linked to adverse cardiovascular health; the population distribution of urinary sodium (UNa) values in the US is unknown. We examined the population distribution of UNa and the validity of existing equations predicting 24-h Na excretion from a single spot urine sample among older adults with and without hypertension. Methods: Demographic, anthropometric, lab, and diet data along with 24-h urine collections were obtained from 555 MESA and CARDIA participants aged 45-79y. One third provided a second 24-h urine collection. Four timed voids (morning, afternoon, evening, and overnight) and the 24-h collection were analyzed for Na, creatinine, potassium and chloride concentrations. We examined the distribution of 24-h excretion of each analyte overall and by gender-race subgroups and hypertensive (HTN) status. We then examined the mean differences (bias) and confidence intervals between measured 24-h UNa excretion and the predicted from spot urine using 4 published equations by specimen timing, race-gender subgroups, and HTN status. Results: Using preliminary data from 265 participants with completed laboratory analysis, 55% female, 61% Black, and 60% had HTN. Mean 24-h Na excretion was 4234 ± 1920 mg for white men, 2706 ± 1136 mg for white women, 3463 ± 1691 mg for Black men and 3415 ± 1635 mg for Black women and did not significantly differ by hypertensive status. Mean bias in predicting 24-h Na excretion overall ranged from -268 (95% CI: -443.5, -91.8) to 1045 (849.3, 1240.4) mg/d. (Table) Conclusion: Among this group of older adults and those with hypertension, the mean 24-h UNa excretion levels for all race-gender groups exceeded current recommendations of 2,300 mg/d, with significant variation by race and gender. All of the four published equations under or overestimated mean 24-h Na excretion when using a single, timed spot urine sample but using evening samples appeared to produce the least bias. These preliminary findings are tentative until confirmed with the full dataset.

scholarly journals A new method to estimate dietary sodium intake from a spot urine sample: context and caution

2021 ◽  
Author(s):  
Matthew J Belanger ◽  
Michael K Lorinsky ◽  
Varayini Pankayatselvan ◽  
Stephen P Juraschek
Keyword(s):  
Urine Sample ◽  
Sodium Intake ◽  
New Method ◽  
Dietary Sodium ◽  
Spot Urine ◽  
Spot Urine Sample

Low sodium to potassium ratio in spot urine sample is associated with progression to acute kidney injury and mortality in hospitalized patients with cirrhosis

2021 ◽  
Author(s):  
Elayne Cristina Morais Rateke ◽  
Camila Matiollo ◽  
Emerita Quintina de Andrade Moura ◽  
Michelle Andrigueti ◽  
Claudia Maccali ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Urine Sample ◽  
Kidney Injury ◽  
Hospitalized Patients ◽  
Spot Urine ◽  
Low Sodium ◽  
Spot Urine Sample

Differential diagnosis of proteinuria in a spot urine sample

2019 ◽  
Vol 493 ◽  
pp. S478-S479
Author(s):  
A. González Raya ◽  
R. Coca Zuñiga ◽  
E. Martín Sálido ◽  
G. Callejón Martín ◽  
A. Lendinez Ramirez ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Urine Sample ◽  
Spot Urine ◽  
Spot Urine Sample

scholarly journals Determining an Upper Reference Value for the Urinary Fluoride-Creatinine Ratio in Healthy Children Younger than 7 Years

2017 ◽  
Vol 51 (4) ◽  
pp. 283-289 ◽  
Author(s):  
F. Vida Zohoori ◽  
A. Maguire
Keyword(s):  
Urine Sample ◽  
Strong Association ◽  
Reference Value ◽  
Epidemiological Studies ◽  
Healthy Children ◽  
Strong Positive Correlation ◽  
Creatinine Ratio ◽  
Spot Urine ◽  
Spot Urine Sample ◽  
Urinary Fluoride

The urinary fluoride/creatinine ratio (UF/Cr) in a spot urine sample could be a useful systemic F exposure monitoring tool. No reference value for UF/Cr currently exists, therefore this study aimed to establish an upper reference value for a UF/Cr, corresponding to excessive systemic F exposure, i.e., >0.07 mg F/kg body weight (b.w.)/day, in children. Subsidiary aims were to examine the relationship between (i) total daily F intake (TDFI) and 24-h urinary F excretion (DUFE); (ii) DUFE and UF/Cr, and (iii) TDFI and UF/Cr. Simultaneously collected TDFI, DUFE, and urinary creatinine (UCr) data in children <7 years were taken from UK studies conducted from 2002 to 2014 in order to calculate UF/Cr (mg/g) for each child. For the 158 children (mean age 5.8 years) included in the data analysis, mean TDFI and DUFE were 0.049 (SD 0.033) and 0.016 (SD 0.008) mg/kg b.w./day, respectively, and the mean UF/Cr was 1.21 (SD 0.61) mg/g. Significant (p < 0.001) positive linear correlations were found between TDFI and DUFE, DUFE and UF/Cr, and TDFI and UF/Cr. The estimated upper reference value for UF/Cr was 1.69 mg/g; this was significantly (p = 0.019) higher than the UF/Cr (1.29) associated with optimal F exposure (0.05-0.07 mg/kg b.w./day). In conclusion, the strong positive correlation between TDFI and UF/Cr confirms the strong association of these 2 F exposure variables and the value of a spot urine sample for prediction of TDFI (i.e., the most important risk factor in determining fluorosis occurrence and severity) in young children. Establishing an estimation of an upper reference value of 1.69 mg/g for UF/Cr in spot urine samples could simplify and facilitate their use as a valuable tool in large epidemiological studies.

scholarly journals Microalbumin measurement alone or calculation of the albumin/creatinine ratio for the screening of hypertension patients?

2002 ◽  
Vol 17 (1) ◽  
pp. 81-85 ◽  
Author(s):  
Ulla Derhaschnig ◽  
Harald Kittler ◽  
Christian Woisetschläger ◽  
Andreas Bur ◽  
Harald Herkner ◽  
...  
Keyword(s):  
Urine Sample ◽  
Diagnostic Performance ◽  
Screening Method ◽  
Creatinine Ratio ◽  
Operating Characteristics ◽  
Albumin Creatinine Ratio ◽  
Hypertensive Patients ◽  
Spot Urine ◽  
Spot Urine Sample ◽  
Receiver Operating Characteristics Curve

Abstract Background. Spot urine sampling seems to be a reliable screening method for the detection of microalbuminuria in hypertensive patients. It remains unclear whether microalbumin measurement alone or calculation of the albumin/creatinine ratio (ACR) are more reliable for the detection of microalbuminuria in non-selected hypertensive patients. Methods. Following collection of a spot, midstream urine sample, urine was collected for 24 h for the measurement of microalbumin in 264 hypertensive patients. We compared microalbumin concentration in the spot urine with microalbumin measured in the 24-h urine sample and examined the utility of the ACR in evaluating microalbuminuria in hypertensive patients. Pathologic microalbuminuria was assumed when the microalbumin concentration exceeded 30 mg/l in the 24-h urine sample. Diagnostic performance is expressed in terms of specificity, sensitivity, positive (PPV) and negative predictive value (NPV), and area under receiver operating characteristics curve (AUC). Results. A total of 47 samples (17.8%) showed pathologic microalbuminuria in the 24-h urine sample. The diagnostic performance expressed as AUC was 0.94 (95% CI 0.90–0.98) for microalbumin measurement alone and 0.94 (95% CI 0.89–0.97) for ACR. The PPV and NPV were 44.2 and 97.9% for microalbumin measurement alone. ACR revealed a PPV of 29.3% and a NPV of 96.2% for males and 42.9 and 98% for females, if a cut-off value of 2.5 mg/mmol for males and of 4.0 mg/mmol for females was used. Conclusions. The ACR did not provide any advantage compared with microalbumin measurement alone, but requires an additional determination of creatinine and the use of gender-specific cut-off values. Therefore, measurement of microalbuminuria alone in the spot urine sample is more convenient in daily clinical practice and should be used as the screening method for hypertensive patients.

scholarly journals Dietary Sodium and Blood Pressure in Older Adults

2006 ◽  
Vol 4 (2) ◽  
pp. 25-46
Author(s):  
Courtney B. Johnson
Keyword(s):  
Public Health ◽  
Blood Pressure ◽  
Older Adults ◽  
Healthy Aging ◽  
Sodium Intake ◽  
Urinary Sodium ◽  
Dietary Sodium ◽  
Food Sources ◽  
Major Food ◽  
Increased Risk

Given the proportion of older adults who are hypertensive and the population of older adults who are at risk for hypertension, the U.S. must mobilize public health efforts aimed at prevention. Scientific evidence has demonstrated the efficacy of sodium reduction to lower blood pressure. Translating this evidence into practice involves knowledge about the food sources of sodium so effective interventions can be designed and implemented. The purpose of this essay was to examine major food group sources of sodium in a cohort of older adults, with and without high blood pressure, in an urban community in Southwestern Pennsylvania. The University of Pittsburgh's "Center for Healthy Aging" promotes healthy aging in the community with the "10 Keys to Healthy Aging" campaign. One of the keys aims to lower systolic blood pressure to ≤140 mmHg. A low sodium intervention was implemented by the CHA project in hypertensive individuals. The sodium intake of the 521 community volunteers, mean age 74.5 years, 60% male, 94.1% white, who completed a FFQ, was compared to a sub-sample of hypertensives (n=214) who, in addition, collected one 24-hour urinary sodium. Mean baseline dietary sodium for the entire cohort was 1,796 mg per day compared to 1,821 mg per day in hypertensives. Urinary sodium was 1.8 times higher (141 mmol/24 hrs [3,240 mg]) than self-reported intake and decreased to 130 mmol/24 hrs (2,990 mg) at 6-months. The correlation between dietary and urinary sodium at baseline was weak (r=0.16) and remained weak (0.23) at 6-months. Major food sources of sodium were soups, breads, tomato sauce, salad dressings, and prepared cereals. Data indicate that the sodium intake of the group exceeds the 2005 Dietary Guidelines of ≤1500 mg per day by approximately 200% for individuals at increased risk using urinary sodium values. Even the most successful dietary interventions to reduce sodium intake to the recommended levels would be ineffective without the food industry’s help in reducing sodium added to foods during processing. This prevention strategy, in combination with stronger public health messages, would help to reduce the sodium intake in the population and help to achieve reductions in blood pressures.

scholarly journals The Role of Intersectionality in Access to Technology Among Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 259-260
Author(s):  
Zainab Suntai ◽  
Susanny Beltran
Keyword(s):  
Older Adults ◽  
Black Women ◽  
Cell Phone ◽  
White Women ◽  
Well Being ◽  
Physical Distance ◽  
Future Research ◽  
Laptop Computer ◽  
Access To Technology ◽  
Working Cell

Abstract In the era of COVID-19, technology has become a primary means of connecting with the world while maintaining physical distance, which is crucial for older adults who are at disproportionately high risk of infection and death. Throughout the pandemic, there has been increased emphasis on using telehealth to access medical and mental health care, and technology (e.g., apps, social media, video calls) for social interactions/communication to mitigate loneliness/isolation. Thus, COVID-19 has increased the need for older adults to access technology, and widened disparities experienced by those with limited access. This study used data from the 2018 National Health and Aging Trends Study, an annual longitudinal panel survey of Medicare beneficiaries aged 65+ in the U.S, to explore the association between the interaction of race/ethnicity and sex, and access to both a working cell phone and laptop/computer. Chi-square tests and multivariable logistic regressions were conducted. The sample (N=2,442) was 83.7% white, 8.5% Black, and 7.8% Hispanic. After accounting for other explanatory variables, logistic regression analysis indicated significantly higher odds of not having both a working cell phone or computer/laptop among White women (OR=1.518, CI=.1.510-1.527), Black men (OR=.1.741, CI= 1.720-1.763), Black women (OR=2.567, CI= 2.545-2.589), Hispanic men (OR=1.036, CI=1.022-1.050), and Hispanic women (OR=2.265, CI=.2.243-2.287) compared to White men. Overall, Hispanic and Black women were the least likely to have access to technology compared to other groups. Addressing technological equity remains a need. Future research should consider how the provision of devices along with technological literary programs can improve well-being among BIPOC women.

scholarly journals Health and Working Beyond Retirement Age: Exploring Racial and Gender Intersectionality

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 570-570
Author(s):  
Ronica Rooks ◽  
Allison Leanage
Keyword(s):  
Older Adults ◽  
Black Women ◽  
White Women ◽  
Longitudinal Research ◽  
Safety Net ◽  
Community Dwelling ◽  
Cross Sectional ◽  
Program Costs ◽  
And Gender ◽  
White Adults

Abstract Little longitudinal research exists on health and working among older racial and ethnic minority adults. Following previous cross-sectional research, we examine the Health, Aging, and Body Composition (HABC) study comparing working vs. not working overtime among older adults. We hypothesize: 1) Black vs. White adults are more likely to work; 2) Black vs. White differences in working are greater among women than men; and 3) Working relates to fewer prevalent health problems than not working. We used gender-stratified descriptive statistics and generalized mixed-effects logistic regression with covariate adjustments to analyze the HABC cohort study, with community-dwelling, well-functioning Black (42%) and White older adults aged 70-79 in year 1 (n=3,069) to year 6 (n=2,091). We found support for all three hypotheses. Black vs. White adults were more likely to work overtime. Women were less likely to work overtime compared to men. White women were less likely to keep working compared to men and Black women. Lastly, older adults with fewer chronic conditions were more likely to continue working. Our study finds racial and gender differences among older adults working overtime. Intersectionality plays a role in older adults’ health and work disparities, leading us to explore the needs and/or benefits of working past retirement in specific groups. Our policy implication is for society to pro-actively invest in older adults’ health and productive activities, which may act as social determinants of health solutions to reduce disparities and growing social safety net program costs.

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