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.

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 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.

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 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 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 Correlation Between Spot Urine Sodium, 24 Hour Urinary Sodium and Food Frequency Questionnairein Estimation of Salt Intake in Healthy Individuals

2020 ◽  
Vol 5 (1) ◽  
pp. 74
Author(s):  
Jaafar Maryam Kamiliah ◽  
Nordin Nani ◽  
Abdul Rahman Abdul Rashid
Keyword(s):  
Salt Intake ◽  
Sodium Intake ◽  
Cost Effective ◽  
Urinary Sodium ◽  
Urine Samples ◽  
Urine Sodium ◽  
Gold Standard Method ◽  
Food Frequency ◽  
Spot Urine ◽  
Daily Sodium Intake

Background:Salt intake is a known contributor to increased blood pressure. However, it is rarely monitored in clinical practice. 24-hr urinary sodium (24-HrNa) is the gold standard method to estimate salt intake but this method is rather burdensome.Objective: The objective of this study is to correlate between spot urine sodium (SUNa), 24-HrNa and Na intake estimation by food frequency questionnaire (FFQ) (FFQNa).Methods : 430 healthy participants aged between 20-40 years old were recruited. Second morning voided urine samples were obtained from all participants to estimate SUNa. 24-HrNa samples were obtained from 77 out of 430 participants. All participants were required to answer a validated FFQ. Urine samples were analysed for Na using indirect ion-selective electrode (ISE) method. Daily sodium intake was calculated from the FFQ.Results:The mean daily sodium intake from 24-hrNa (n=77) was 155 mmol/day, SUNa (n=430) was 158 mmol/L and FFQNa (n=430) was 271 mmol/day. There was a moderate correlation between SUNa and 24-hrNa (ρ = 0.62, P < 0.000). No correlation was seen between both 24-hrNa and SUNa with FFQNa (ρ = 0.035, P = 0.768 and ρ = 0.026, P = 0.597 respectively).Conclusion: Spot urine Na is a simple cost-effective method to estimate daily Na intake and has the potential to replace 24-hour urinary Na.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 74-80

scholarly journals Diagnostic usefulness of the spot urine sodium/potassium ratio in cirrhotic patients with ascites

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253886
Author(s):  
Jin Wook Lee ◽  
Jae Seok Hwang ◽  
Woo Jin Chung ◽  
Heon Ju Lee ◽  
Jung Gil Park ◽  
...  
Keyword(s):  
Urine Samples ◽  
Urine Collection ◽  
Urine Sodium ◽  
Salt Diet ◽  
Spot Urine ◽  
Number Of Patients ◽  
Low Salt ◽  
Diagnostic Usefulness ◽  
Diet Compliance ◽  
Cirrhotic Patients

Background and aims The low-salt diet is considered important for control of ascites in cirrhotic patients. To validate whether the spot urine sodium (Na)/potassium (K) ratio could replace 24-h urine Na (uNa) excretion in assessing low-salt diet compliance. Methods We prospectively studied 175 patients. 24-h urine collection and spot urine collection were performed. Subsequently, 24-h uNa, urine creatinine (uCr), and spot urine Na and K were assessed. A complete urine collection was confirmed based on 24-h uCr excretion levels of 15mg/kg/day for men and 10mg/kg/day for women. The area under the receiver operating characteristic (AUROC) curve analysis was performed to evaluate the feasibility of spot urine Na/K ratio in predicting 24-h uNa greater than 78mmol/day. Results Out of 175 patients, 24-h urine samples were completely collected in 57 patients only. Moreover, urine samples were not completely collected in 118 patients because their 24-h uCr excretion level was less than the established criteria. In complete urine collection group, AUROC curve for spot urine Na/K ratio in predicting 24-h uNa greater than 78mmol/day was 0.874±0.051 (P<0.001). In the incomplete urine collection group, the AUROC was 0.832±0.039 (P<0.001). In complete urine collection group, the classical cutoff value greater than 1.0 of spot urine Na/K ratio showed 90.9% sensitivity and 56.0% specificity. Conclusions The spot urine Na/K ratio reflects 24-h uNa, but the AUROC value obtained in this study is lower than that of a previous study. Considered the large number of patients with incomplete urine collection, validating 24-h complete urine collection criteria is necessary.

Use of mean spot urine sodium concentrations to estimate daily sodium intake in patients with chronic kidney disease

Nutrition ◽  
2012 ◽  
Vol 28 (3) ◽  
pp. 256-261 ◽  
Author(s):  
Shin Sook Kang ◽  
Eun Hee Kang ◽  
Seon Ok Kim ◽  
Moo Song Lee ◽  
Changgi D. Hong ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Sodium Intake ◽  
Urine Sodium ◽  
Spot Urine ◽  
Daily Sodium Intake

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).

Use of Double Cross-Validation and Bootstrap Methods to Estimate Replicability of Results of Multiple Regression

1998 ◽  
Vol 86 (3_suppl) ◽  
pp. 1143-1152 ◽  
Author(s):  
Rebecca P. Ang
Keyword(s):  
Multiple Regression ◽  
Cross Validation ◽  
Statistical Significance ◽  
Significance Testing ◽  
Data Set ◽  
Bootstrap Methods ◽  
Bootstrap Procedure ◽  
Microcomputer Program ◽  
Validation Procedure ◽  
Double Cross

Researchers have all too often ignored replicability of results because they overly rely on significance testing. This is a misinformed view because statistical significance does not evaluate the importance or replicability of a result. This paper focuses on two methods of assessing replicability of results, double cross-validation and bootstrap procedures. Selected variables from Hughes, Cavell, and Grossman's (1997) data set of 112 cases are used to illustrate all these techniques as applied to the interpretation of multiple regression results. One statistical computer package SPSS is used for the double cross-validation procedure, and a 1987 microcomputer program package of Lunneborg is used to demonstrate the bootstrap procedure.

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