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.

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 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

Low correlation between morning spot and 24-hour urine samples for estimating sodium intake in an Iranian population: Isfahan Salt Study

2019 ◽  
Vol 89 (3-4) ◽  
pp. 185-191
Author(s):  
Alireza Khosravi ◽  
Noushin Mohammadifard ◽  
Mojagn Gharipour ◽  
Zahra Abdollahi ◽  
Fatemeh Nouri ◽  
...  
Keyword(s):  
Sodium Excretion ◽  
Salt Intake ◽  
Iranian Population ◽  
Urine Samples ◽  
Potassium Excretion ◽  
Urine Sodium ◽  
Gold Standard Method ◽  
Spot Urine ◽  
Sodium And Potassium ◽  
Tanaka Formula

Abstract. Introduction: Although difficult, the 24-hour urine sodium excretion is still considered as the gold standard method to estimate salt intake. The current study aimed to assess the validity of using spot urine samples in comparison with the standard 24-hour urine collection to estimate sodium and potassium intake in healthy Iranian adults. Methods and subjects: This cross-sectional study was performed on 1099 healthy Iranians aged 18–69 years. Samples of 24-hour and fasting morning spot urine were collected to measure sodium and potassium excretions. Tanaka’s formula was utilized to predict the 24-hour sodium and potassium urinary excretions based on the spot values. Results: The difference between measured and estimated sodium excretion values was 4265 mg/day (95% CI: 4106–4424; P < 0.001) and 2242 mg/day in case of potassium excretion (95% CI: 2140–2344; P < 0.001). There was a weak significant correlation between the 24-hour urine sodium and potassium excretion and the predicted values (intraclass correlations: 0.22 and 0.28, respectively; both P < 0.001). Conclusion: The weak association between the predicted and measured values of sodium and potassium along with the marked overestimation of daily sodium and potassium excretions based on the spot urine and using Tanaka formula indicates that Tanaka formula is not practical for the prediction of sodium and potassium or salt intake in Iranian adults. Using other spot urine sampling times and/or adopting a formula designed based on the characteristics of the Iranian population may increase the validity of spot urine tests.

A Strong Correlation Between Spot Urine Protein To Creatinine Ratio and 24-Hour Urine Protein Quantification For Proteinuria Assessment In Patients With Plasma Cell Dyscrasia

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3155-3155
Author(s):  
Apuri Susmitha ◽  
Taiga Nishihori ◽  
Karen Lin ◽  
Rachid Baz ◽  
Binglin Yue ◽  
...  
Keyword(s):  
Correlation Coefficient ◽  
Plasma Cell ◽  
Protein Quantification ◽  
Urine Samples ◽  
Urine Collection ◽  
Spearman Correlation ◽  
Urine Protein ◽  
Monoclonal Protein ◽  
Spot Urine ◽  
M Spike

Abstract Background Twenty four-hour urine collection remains one of the most crucial tools for the diagnosis and monitoring of proteinuria and quantification of urinary monoclonal protein in patients with plasma cell dyscrasias (PCD) even though it is cumbersome. Nephrology guidelines recommend replacement of 24-hour urine collection with a spot urine protein/creatinine (Pr/Cr) ratio for the measurement of proteinuria. However, only limited data exist regarding accuracy of spot urine Pr/Cr ratio in patients with PCD and utility of this measure to estimate urinary paraprotein remains uncertain. We conducted a prospective study evaluating the role of spot urine Pr/Cr ratio in patients with PCD. Methods From 04/2012 to 05/2013, a total of 120 PCD patients were prospectively enrolled at Moffitt Cancer Center. Oliguric patients or those requiring dialysis were ineligible. Spot urine was collected on the same day as 24-hour urine collection. Spot urine Pr/Cr ratios were compared to 24-hour urine collections with regard to the amount of (1) total protein and (2) monoclonal protein (M-spike). Results Eighty four out of 120 patients (70%) were evaluable (17 did not provide spot urine samples; no Pr/Cr ratios available in 11; protein below the level of detection in 7; and one without 24-hour urine collection). Evaluable patients had a median age of 68 (range, 36 - 90) years, 63% were male, and 85% were Caucasian. Primary diagnoses were myeloma (n=74; 88%), amyloidosis (n=4), multiple plasmacytomas (n=2), solitary plasmactyoma (n=1) and MGUS (n=3). Prior therapies included chemotherapy in 95% and autologous transplant in 45%. Comorbidities included hypertension (48%), chronic kidney disease (30%), diabetes (15%), coronary artery disease (8%), atrial fibrillation (7%) and congestive heart failure (2%). The median serum creatinine was 0.9 mg/dL (range, 0.5 - 5.1). The median spot urine Pr/Cr ratio was 137 mg/g creatinine (range, 26 - 21,447). The median 24-hour urine protein was 120 mg/24h (range, 27 - 15,092), and the median urine M-spike was 1.2 mg (range, 0 - 8,099). More than half of spot urine samples were collected in the morning (59%). There were strong correlations between (1) spot urine Pr/Cr ratio and 24-hour total urine protein (Spearman correlation coefficient=0.91, p < 0.0001), and (2) spot urine Pr/Cr ratio and 24-hour urine M-spike (Spearman correlation coefficient=0.91, p < 0.0001). The timing of spot urine sample collection had no significant effects on the correlations (p = 0.46 and 0.95 by Wilcoxon rank-sum test). Conclusions Spot urine Pr/Cr ratio strongly correlates with degrees of proteinuria measured in 24-hour urine collection and may also predict the quantity of urine M-spike in non-oliguric PCD population. Spot urine Pr/Cr ratio is a potentially useful marker as a screening tool or an alternative semi-quantitative measure for rapid estimation of proteinuria which may be used for longitudinal patient follow-up in lieu of cumbersome repeated 24-hour collections. Disclosures: No relevant conflicts of interest to declare.

scholarly journals Comparative study of spot urine Na/K ratio and 24-hour urine sodium in natriuresis evaluation of cirrhotic patients with ascites

2014 ◽  
Vol 21 (1) ◽  
pp. 15-20 ◽  
Author(s):  
Otávio Marcos da Silva ◽  
Gabriela Bicca Thiele ◽  
Leonardo Fayad ◽  
César Lazzarotto ◽  
Esther Buzaglo Dantas-Corrêa ◽  
...  
Keyword(s):  
Comparative Study ◽  
Urine Sodium ◽  
Spot Urine ◽  
Cirrhotic Patients

Validation of diagnostic usefulness of the spot urine Na/K ratio for replacement of 24-hour urine NA excretion in cirrhotic patients with ascites

2020 ◽  
Vol 73 ◽  
pp. S728-S729
Author(s):  
Jinwook Lee ◽  
Jae-Seok Hwang ◽  
Woo Jin Chung ◽  
Heonju Lee ◽  
Jung Gil Park ◽  
...  
Keyword(s):  
Spot Urine ◽  
Diagnostic Usefulness ◽  
Cirrhotic Patients

scholarly journals Perbandingan kandungan iodium dalam urin antara sampel urin 24 jam dan on spot pada anak usia sekolah

2017 ◽  
Vol 13 (3) ◽  
pp. 129
Author(s):  
Widya Ayu Kurnia Putri ◽  
Dodik Briawan ◽  
Hidayat Syarif ◽  
Leily Amelia
Keyword(s):  
Iodine Concentration ◽  
Cross Sectional Study ◽  
Urine Samples ◽  
School Age Children ◽  
Healthy Children ◽  
Urine Collection ◽  
Cross Sectional ◽  
Iodine Status ◽  
Spot Urine ◽  
Epidemiological Surveys

Background: Urine Iodine Concentration (UIC) is the indicator to assess iodine status. UIC from 24-hour urine collection appropriate to used as a direct measure of the iodine status and helps to validate the estimates intake of iodine. 24-hours urine collection is not practical in large studies and epidemiological surveys because it is quite difficult to complete and accurate collection. WHO/UNICEF/ICCIDD recommend the use of on spot urine collection.Objective: The aim of this study was to compare of 24-hour urine collection and spot urine collection for the assessment UIC in children.Method: The cross-sectional study was applied in Bogor. UIC was measured in 24-hour urine and parallel collected three spot urine namely on spot 1 collected morning, on spot 2 collected afternoon, and on spot 3 collected evening, sample urine collected from 44 healthy children age 10-13 years. UIC of 24-hour urine and one spot urine analyzed in the laboratory GAKY FK UNDIP using acid digestion method.Results: The average UIC from 24-hour urine collection was 179.77 ± 56.4 µg/l and UIC from on spot urine collection were on spot morning 145.30 ± 63.6 µg/l, on spot afternoon 159.95 ± 64.5 µg/l, and on spot evening 167.50 ± 66.1 µg/l. However, UIC correlation between UIC from on spot afternoon and UIC 24-hour (r = 0.456) with 66.67 % sensitivity and 75.61 % specificity.Conclusion: UIC urine samples from lunch to dinner more accurately reflects the UIC 24 hours to categorize the iodine status of the population. UIC from spot urine samples collected on the afternoon can be used as an alternative to evaluate the iodine status of school-age children.

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 Evaluation of using spot urine to replace 24 h urine sodium and potassium excretions

2014 ◽  
Vol 17 (11) ◽  
pp. 2505-2511 ◽  
Author(s):  
Eveline JC Hooft van Huysduynen ◽  
Paul JM Hulshof ◽  
Linde van Lee ◽  
Anouk Geelen ◽  
Edith JM Feskens ◽  
...  
Keyword(s):  
Accurate Method ◽  
Urine Samples ◽  
Large Individual ◽  
Urine Sodium ◽  
Spot Urine ◽  
Study Centre ◽  
Urine Concentrations ◽  
The Mean ◽  
Caucasian Women ◽  
Sodium And Potassium

AbstractObjectiveThe most accurate method to estimate Na and K intakes is to determine 24 h urinary excretions of these minerals. However, collecting 24 h urine is burdensome. Therefore it was studied whether spot urine could be used to replace 24 h urine samples.DesignParticipants collected 24 h urine and kept one voiding sample separate. Na, K and creatinine concentrations were analysed in both 24 h and spot urine samples. Also 24 h excretions of Na and K were predicted from spot urine concentrations using the Tanaka and Danish methods.SettingIn 2011 and 2012, urine samples were collected and brought to the study centre at Wageningen University, the Netherlands.SubjectsWomen (n147) aged 19–26 years.ResultsAccording top-aminobenzoic acid excretions, 127 urine collections were complete. Correlations of Na:creatinine, K:creatinine and Na:K between spot urine and 24 h urine were 0·68, 0·57 and 0·64, respectively. Mean 24 h Na excretion predicted with the Tanaka method was higher (difference 21·2 mmol/d,P<0·001) than the measured excretion of 131·6 mmol/d and mean 24 h Na excretion predicted with the Danish method was similar (difference 3·2 mmol/d,P=0·417) to the measured excretion. The mean 24 h K excretion predicted with the Tanaka method was higher (difference 13·6 mmol/d,P<0·001) than the measured excretion of 66·8 mmol/d. Bland–Altman plots showed large individual differences between predicted and measured 24 h Na and K excretions.ConclusionsThe ratios of Na:creatinine and K:creatinine in spot urine were reasonably well associated with their respective ratios in 24 h urine and appear to predict mean 24 h Na excretion of these young, Caucasian women.

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