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Both veganism and high dietary acid load are linked to unfavorable bone health. However, the specific role of dietary alkali or acid load for the bone health of vegans is so far unknown. Thus, the renal biomarker for dietary acid or alkali load, i.e., urinary potential renal acid load (uPRAL), was measured in 24 h urine samples of 34 vegans and 35 omnivores (50.7% males). Bone health was assessed via calcaneal quantitative ultrasound. Associations between uPRAL and bone health indices were examined using multivariable general linear models. Compared to omnivores, vegans had a significantly lower uPRAL (mean difference = −34.5 mEq/24 h, p < 0.0001), a lower 24 h urinary phosphate excretion (p = 0.0004), a lower 24 h urinary sulfate excretion (p = 0.01), and a higher urine pH value (p < 0.0001). Broadband ultrasound attenuation (BUA) was lower among vegans versus omnivores (p = 0.037), yet it was not associated with uPRAL irrespective of adjustments. This study confirms different acid-base profiles of vegans and omnivores, with a pronounced alkaline excess among vegans and a rather low acid load among a group of omnivores with moderate protein intake. Within this spectrum of alkaline to low acid load, no association with bone health was found.

Spot urine specimens have been used to estimate 24 h urinary sodium (Na) excretion (24UNaV) and potassium (K) excretion (24UKV). However, the validity is limited for 24UNaV and unknown for 24UKV in stroke patients, using the existing formulas. Herein, we developed and validated a new formula for 24UNaV and 24UKV by spot urine specimens in stroke patients. Spot and 24 h urine samples were collected from 970 stroke patients. The models of 24UNaV and 24UKV were developed using stepwise multivariate linear regression in 689 patients. The performance of different formulas was internally validated in 281 patients at the population and individual levels. The obtained new formulas were: (1) estimated 24UNaV (mmol/day): −0.191 × Age + 4.349 × BMI + 0.229 × SpotNa + 1.744 × SpotNa/Spot creatinine (Cr) + 41.492 (for male); −1.030 × Age + 2.011 × BMI + 0.143 × SpotNa + 1.035 × SpotNa/SpotCr + 147.159 (for female); and (2) estimated 24UKV (mmol/day): −0.052 × Age + 0.410 × BMI + 0.031 × SpotK + 33.280 × Ln (spotK/spot Cr) − 5.789 × Ln (spotNa/spot Cr) − 1.035 (for male); −0.235 × Age + 0.530 × BMI + 0.040 × SpotK + 30.990 × Ln (spot K/spot Cr) − 7.837 × Ln (spotNa/spotCr) + 4.318 (for female). The new formula obtained the lowest mean bias (5.17 mmol/day for 24UNaV and 0.85 mmol/day for 24UKV) and highest proportion at the cutoff under the ±30% level for the estimation of 24UNaV (59.43%) and 24UKV (70.11%). The new formula provides a meaningful exploration to estimate 24UNaV and 24UKV in stroke patients by using spot urine specimens.

The relationship between 24-h urinary phosphorus excretion (24 h UPE) and cardiovascular disease in patients with pre-dialysis chronic kidney disease (CKD) has rarely been studied, despite the fact that the relationship between serum phosphorus level and the risk of a cardiovascular event is well established. A total of 1701 patients with pre-dialysis CKD were finally included for the analyses and were divided into tertiles by 24 h UPE (first tertile (T1, 349.557 (mean) ± 88.413 (standard deviation)), second tertile (T2, 557.530 ± 50.738), and third tertile (T3, 851.695 ± 171.593). The study outcome was a six-point major adverse cardiac event (MACE). The median follow-up duration was 7.992 years. Kaplan–Meier curve analysis visualized that the cumulative incidences of a six-point MACE (p = 0.029) significantly differed from 24 h UPE levels, as the incidence rate of the study outcomes was highest in T1 and lowest in T3. Cox proportional hazard models unveiled that, compared to T1, the risk of a six-point MACE was significantly decreased in T3 (adjusted hazard ratio (HR) 0.376, 95% confidence interval (CI) 0.207 to 0.683). The restricted cubic spline curve analysis visualized an inverted S-shaped association between 24 h UPE level and the risk of a six-point MACE, indicating a significantly increased risk of a six-point MACE in patients with a low 24 h UPE level. In conclusion, low 24 h UPE is associated with adverse cardiovascular outcomes in patients with CKD. Our finding emphasizes that low 24 h UPE should not be a reliable marker for dietary restriction of phosphorus that essentially leads to better outcomes in patients with CKD.

Intakes of excess Na and insufficient K are two major contributors of heart diseases and stroke development. However, no precise study has previously been carried out on Na and K intakes among Indonesian adults. The present study aimed to estimate the Na and K intakes using two consecutive 24-h urine collections. Participants were community-dwelling adults aged between 20 and 96 years, randomly selected from a pool of resident registration numbers. Of the 506 participants, 479 (240 men and 239 women) completed urine collections. The mean Na excretion was 102·8 and 100·6 mmol/d, while the mean K excretion was 25·0 and 23·4 mmol/d for men and women, respectively. Na and K excretions were higher in participants with a higher BMI. A higher K excretion was associated only with younger age. More than 80 % of the participants consumed more than 5 g/d of salt (the upper limit recommended by the Indonesian government), whereas none of them consumed more than 3510 mg/d of K (the lower limit). The high Na and low K intakes, especially high Na among participants with high BMI, should be considered when future intervention programmes are planned in this country.

This cross-sectional study was undertaken to compare 24-h urine protein estimation with spot urine protein-creatinine ratio (PCR). 72 patients having proteinuria of > 150 mg/day were included in this study. 24-h urine total protein (UTP) test were also asked to give their mid-morning spot urine sample the following day for urine protein-creatinine ratio. The subjects were grouped according to their UTP into Groups as described follows: Group A 3.5 g/day. Pearson’s correlation (r) and paired Student’s T test were done. The paired T test showed no difference in the UTP and PCR in the subgroup having qualitative protein of zero and in group A. There was no agreement between the two methods used for quantitation. In the overtly proteinuric patients, the correlation between the UTP and PCR was positive in group A which was statistically significant (p = 0.05) whereas it was not significant (p = 0.07) in group B. Though there was a negative correlation in the massive proteinuria group C it was not significant (p = 0.65). Our study demonstrates that spot PCR can be reliable parameter for initial diagnostic criterion of proteinuria but for follow-up measurements and for proteinuria > 0.5 gm/day, 24-h UTP is the single most accurate measurement of protein excretion.

Kidney disease is a global public health problem, affecting over 750 million people worldwide. Glomerular Filtration Rate(GFR), which is calculated by measuring the creatinine clearance with 24-hour urine collection (CC) can be inaccurate due toimproper urine collection, causing the need for an easier and accurate method of calculation. This study was anobservational analytical cross-sectional research using consecutive retrospective sampling. Samples were data of patientswith Chronic Kidney Disease (CKD) who underwent CC test at the Clinical Pathology Laboratory of the Dr. Soetomo HospitalSurabaya during September-October 2018. Data were compared with the results of Cockcroft-Gault (CG), MDRD, andCKD-Epi formula, and were analyzed using the one-sample Kolmogorov-Smirnov test, paired T-test, and Wilcoxon SignedRank test. Correlation of CC results with CG, MDRD, and CKD-Epi results was tested with Spearman's rho and Bland Altmantest. The difference test of CC with CG, MDRD, and CKD-Epi showed results of (p=0.000), (p=0.194), and (p=0.468),respectively. There were significant differences between CC compared to CG, but not MDRD and CKD-Epi. There was amoderate correlation between CG, MDRD, CKD-Epi, and CC with r=0.529; 0.448, and 0.463, respectively. The mostcompatible formula was CKD-Epi. The measurement of GFR with CC correlated with CG, MDRD, and CKD-Epi; therefore, theycould be used as an alternative method to calculate GFR. Further experiments using an exogenous marker should beperformed to determine a suitable eGFR formula according to the degree of damage to the kidney.

Objectives To determine if alternative alkalinizing agents lead to similar changes in 24-hour urine pH and citrate compared to potassium citrate (KCIT). Many stone formers cannot tolerate KCIT due to side effects or cost. In these patients, we have prescribed potassium bicarbonate or sodium bicarbonate as alternative alkali (AA), though their efficacy is unclear. Methods We performed a retrospective cohort study of adult stone formers seen from 2000 to 2018 with 24-hour urine analyses. Two analyses were performed. The first evaluated the alkalinizing and citraturic effects in patients with baseline low urine pH or hypocitraturia off of any alkalinizing medications, who were subsequently treated with either KCIT or AA. The second analysis compared the pH and citrate in patients changing from KCIT to an AA. Reasons for switching were abstracted by chart review and cost savings percentages were calculated using GoodRx medication prices. Results When starting alkali therapy, the median increase in pH from baseline was 0.64 for KCIT and 0.51 for AA (P = .077), and the median increase in citrate from baseline was 231 mg for KCIT and 171 mg for AA (P = .109). When switching alkali therapy, median pH and citrate did not significantly change. Hyperkalemia (24%), GI upset (19%), and cost (17%) were the most common reasons cited for switching to an AA. AA represented a savings of 86%-92% compared to KCIT. Conclusion Alternative alkali appear to offer comparable improvements in 24-hour urine parameters and significant cost-savings compared to KCIT.

OBJECTIVE A 24-hour urine nor/metanephrine (urine NM-MN) measurements are a recommended first step in pheochromocytoma diagnosis. We hypothesized the presence of renal impairment (CKD) significantly confounds the results obtained in a urine NM-MN collection, giving artificially lower measurements. DESIGN Retrospective review of a comprehensive laboratory database with all urine NM-MN results from Southern Alberta from 2010 to 2018 (n = 15 505). After excluding high probability pheochromocytoma cases, results from patients with three levels of CKD (n = 796) were compared to those without CKD to determine the potential CKD effect. PATIENTS All patients having urine NM-MN collection during the time period, irrespective of ordering physician or test indication. MEASUREMENTS Urine NM-MN was measured by liquid chromatography-tandem mass spectrometry and glomerular filtration rate determined within a median of 1.9 days, as estimated by CKD-EPI equation. RESULTS In subjects with mild-to-moderate renal impairment, there was no continuous gradient between subnormal renal function and urine NM-MN measures. When the estimated GFR was

BACKGROUND There is little information available on quantitative description of the relationship between urine albumin-to-creatinine ratio (ACR) and 24-h urine protein excretion (24-h UPE). Here, we developed a calculation tool for 24-h UPE using the urine ACR and limited information on the request form. MATERIAL AND METHODS This was a retrospective and observational study. All individuals with same-day urine ACR and 24-h UPE tests in Sichuan Provincial People's Hospital from September 1, 2018 to December 31, 2019 were enrolled. Correlation and agreement between urine ACR and 24-h UPE were evaluated using correlation analysis and an intraclass correlation coefficient, respectively. The Durbin-Watson test and ANOVA were used to assess the performance of the calculation tool, and reliability of the prediction equation was evaluated in the validation group using residual error analysis. RESULTS A total of 906 participants were enrolled, including 639 participants in the development group and 267 in the validation group. Natural logarithm transformation was applied to remove skewness. Natural logarithm-transformed urine ACR correlated well with natural-logarithm-transformed 24-h UPE (Pearson coefficient=0.908; P0.001) and the agreement was consistently good (overall ICC=0.938; 95% CI: 0.928-0.947; P0.001). The multivariable regression model had good performance (R²=0.864) and high accuracy, demonstrated by results of residual error analysis. CONCLUSIONS We provide a practical calculation tool to estimate total protein excretion using urine ACR and readily accessible variables. However, 24-h UPE is still mandatory when proteinuria is over 10 g/day or when most proteinuria may not be of glomerular origin.

Background: Although 24-hour urine total protein (UTP) measurement is the gold standard method for detecting proteinuria in preeclamptic women, the procedure is lengthy and time consuming that might result in delay in diagnosis of the condition. This study aimed at deter­mining the correlation between these 2 parameters. Methods: This was a cross-sectional study done on 50 pregnant women with preeclamp­sia admitted at Bharatpur Hospital from September 2018 - January 2019. Patient with pre­eclampsia and having albumin ≥1 on urine dipstick, the sample was collected in every 12 hours interval on two separate well labeled container with the assistance of nursing staff. Total urine protein at 12-hour and 24-hour were measured by spectrophotometric method. The data were analyzed using SPSS version 21. Correlation between the 2 measurements was analyzed using Spearman’s rank correlation coefficient. p

Few population-based studies conducted in the Eastern Mediterranean region assessed salt intake by the measurement of 24-h sodium urine excretion (24-hUNa). The current study aimed to assess the trend of mean salt intake in Iranian adults between 1998 and 2013.These cross-sectional studies were performed on 564, 157, 509 and 837 randomly selected healthy adults aged18 years from Isfahan city, Iran, in 1998, 2001, 2007 and 2013, respectively. BP was measured using a mercury sphygmomanometer according to a standard protocol. Single 24-h urine was collected to assess 24-hUNa as a surrogate of salt intake, and 24-h urinary K (24-hUK). The estimated trend of salt intake was 9.5, 9.7, 9.6 and 10.2 g/day in total population (P 0.001). The increase in salt intake between 1998 and 2013 was significant only in men, (P 0.001). The risk of pre-hypertension was 21% and 18% significantly greater in the highest quartiles of UNa/UK after adjustment for potential confounders in 2001 and 2013, respectively, [OR (95% CI): 1.21 (1.03-1.64) and 1.18 (1.02-1.38), respectively].This population-based study indicated that mean salt intake was about two times of recommendation in Isfahan city, Iran, and suggest that it would be essential to implement a salt reduction strategy program in Iranian population. Longitudinal national studies with larger samples examining the trend of salt intake are warranted.

PURPOSE OF REVIEW Evaluation of the kidney stone patient includes measurement of 24 h urine chemistries. This review summarizes the application of physiologic principles to the interpretation of urine chemistries, using sulfate and ammonium to estimate diet acid load, and the renal response. RECENT FINDINGS There has been increased recognition of the need to measure urine ammonium excretion in the clinical setting in order to understand renal acid excretion. Some 24 h urine kidney stone panels include ammonium measurements, providing an opportunity to apply this measurement to clinical practice. In order to better interpret ammonium excretion, one needs an estimate of dietary acid load to understand the driving forces for ammonium excretion. Sulfate is also included in some kidney stone panels and functions as an estimate of diet acid load. Combining these analytes with urine pH, the clinician can quickly estimate dietary stone risk as well as potential bowel disease, acidification disorders, and the presence of urease producing bacteria; all of which can affect stone risk. SUMMARY Measurement of ammonium and sulfate excretion along with urine pH provide important insights into the acid/alkali content of diet, presence and severity of bowel disease, presence of renal acidification disorders, and urinary infection.

INTRODUCTION AND OBJECTIVE:To enable earlier preventative interventions or guide empiric therapy for kidney stone disease, our objective was to demonstrate feasibility of predicting 24-hour urine a...

INTRODUCTION AND OBJECTIVE:Recent studies show no benefit to a selective approach to preventive pharmacological therapy (PPT) for patients with urinary stone disease (i.e., obtaining 24-hour urine ...

This study aimed to investigate diet quality in healthy pregnant women based on the Na-to-K ratio from 24 h urine sample and food frequency questionnaire (FFQ), to compare dietary micro- and macronutrient intake with current nutritional recommendations (RDA), and to investigate whether gestational weight gain (GWG) is associated with Na-to-K ratio and diet quality during pregnancy in general. Sixty-four healthy pregnant women between 37 and 40 weeks of gestation participated in the study. Participants’ GWG, body composition, molar 24 h urine Na-to-K ratio, and FFQ data on average daily total energy, food groups, and micro-/macronutrient intake were obtained. A Na-to-K ratio of 2.68 (1.11–5.24) does not meet nutrition quality and is higher than the WHO recommendations due to excessive sodium and insufficient potassium intake. FFQ Na-to-K ratio was associated with a higher daily intake of soups, sauces, cereals, fats, and oils and a low intake of fruit and non-alcoholic beverages. A total of 49% of pregnant women exhibited excessive GWG, which was attributed to the increase in adipose tissue mass. GWG was not associated with total energy but may be the result of insufficient physical activity during pregnancy. Daily intake of vitamin D, vitamin E, folate, niacin, riboflavin, calcium, iron, and zinc was suboptimal compared to RDA.

In vitro experiments demonstrate calcium oxalate (CaOx) supersaturation (SS) drives CaOx nucleation and growth. We investigated the link between 24-hour urine SS CaOx and in vivo stone growth through a natural history, imaging study.Using an institutional review board-approved database, we sought80% CaOx stone formers who prior to stone intervention obtained 2 separate computerized tomography (CT) scans with at least one 24-hour urine collection between scans. Two blinded reviewers calculated bilateral 3-dimensional stone volume using the Visage 7® region of interest pen tool. CT volume difference was divided by time between scans, and SS CaOx was grouped into low (5), medium (5-10) and high risk (10). Statistical significance between groups was assessed by Kruskal-Wallis test.We identified 80 individuals with stone growth measured by 3-dimensional CT (mean ∼7 months between studies). Inter-reviewer reliability of CT volume measurement was well correlated (0.98, Gwet's AC2), and an arbitrator was only needed in 13/160 (8%) cases. Median stone volume growth/year was 15%, 71% and 177% for low, medium and high risk groups, respectively (p0.001). Despite inter-individual variation, best fit of mean SS CaOx vs stone volume growth was moderately correlated (Spearman's rho=0.53, p0.001).In a population of pure CaOx stone formers, increased 24-hour SS CaOx risk was associated with increased in vivo stone growth. Further investigations using CT volumetric stone growth may allow for the noninvasive study of stone growth modulators, improved stone risk prediction and development of a kidney stone simulator.

Hemodialysis adequately controls serum uric acid (UA) levels, making UA-lowering drugs unnecessary; scant data are available for peritoneal dialysis (PD). We analyzed blood, 24 h urine and dialysis fluid from twenty patients under PD, to assess UA levels and clearances, and factors associated with better performance and maintenance of target levels (

The purpose of this review paper is to describe the 24-h urine collection in terms of its utility, collection process, and common problems with its acquisition. Although 24-h urine collections are standard of care for high-risk stone formers, several nuances in test acquisition including inaccurate urine collections 50% of the time and poor patient compliance limit its potential utility. Compliance in obtaining 24-h urine collections has been shown to be improved in patients who have not undergone surgical treatment of urinary calculi, patients with metabolic stone disease or family history of stone disease, Caucasian ethnicity, and in those with more sedentary occupations. Studies show conflicting data of compliance regarding patient age and gender. Physicians must understand the difficulties regarding 24-h urine collections including patient compliance, variability between collections, and complexities with interpretation to best utilize this tool in guiding clinical management for the treatment of nephrolithiasis.

ispartof: KIDNEY INTERNATIONAL vol:98 issue:3 pages:782-784 ispartof: location:United States status: published

Background The 24-h urinary output of 5-hydroxyindoleacetic acid (5-HIAA) is used to monitor disease progression and treatment responses of neuroendocrine neoplasms (NENs). Several conditions are required for 5-HIAA assay, involving urine collection/preservation and food/drug restrictions. Aim To evaluate the correlation between 5-HIAA concentration in a spot urine sample and the output in a 24-h urine collection, and whether spot urine specimens can replace 24-h collection. Methods Patients with NENs or symptoms suggestive of NENs were asked to provide a separate spot urine at the end of the 24-h urine collection for 5-HIAA assessment. The upper reference limit for 24-h urinary 5-HIAA was 40 µmol/24 h. 5-HIAA measurements in spot urine samples were corrected for variation in urine flow rate by expressing results as a ratio to creatinine concentration. Results We included 136 paired urinary samples for 5-HIAA assessment from 111 patients (100 NENs). The correlation between 5-HIAA values measured in 24-h and spot urines was r = +0.863 (P r = +0.840 (P P P Conclusions The ratio of 5-HIAA to creatinine in a spot urine could replace the measurement of 5-HIAA output in a 24-h urine collection, especially for follow-up of patients with known elevated 5-HIAA levels.

We aim to describe factors that are associated with kidney stones 20 mm or larger. This information would potentially guide research regarding factors of kidney stone growth. We retrospectively reviewed a patient cohort who underwent surgical treatment for kidney stones. Patients with detailed demographics, 24-h urine testing, and kidney stone profiling were included. Large stone was defined as measuring 20 mm or more. Univariate analysis was conducted to assess variables associated with kidney stones larger than 20 mm. Multivariate logistic regression and statistical machine learning methods were used to infer prediction models. The specific composition of kidney stones, laboratory testing results, and detailed demographics of 277 patients were included in our analysis. Multiple variables were significantly associated with large stones in univariate analysis. The final model that predicts large stone size includes several variables from different domains: hypertension (OR = 1.91; 95% CI 1.06, 3.43), older age (60+ vs 20–40) (OR = 2.46; 95% CI 1.07, 5.63), decreased calcium oxalate supersaturation (OR = 0.92; 95% CI 0.85, 0.99), and higher percentage of protein in stone composition (OR = 5.64; 95% CI 2.04, 15.58). This model yields a sensitivity 83% and specificity of 56%. Models using machine learning algorithms identified similar predictors, but the performance varies. Our model yielded good performance, and it could potentially be used as a clinical tool for predicting large stones and identifying factors affecting kidney stone growth. Similar analysis in other cohorts should be pursued to externally validate findings.

24-h urine free cortisol (UFC) is an indicator of integrated cortisol secretion and established screening tool for Cushing's syndrome (CS). Doubts have been raised regarding specificity of immunoassays, and mass spectrometric techniques have been proposed as an alternative. In the present study we compared diagnostic accuracy of UFC measured with LC-MS/MS vs. immunoassay in patient with CS and patients where CS has been excluded. We examined 24-h urine samples from patients with surgically confirmed CS (n = 77; Cushing's disease (n = 44), ectopic CS (n = 5), adrenal CS (n = 28)) and patients in whom Cushing's syndrome was excluded (n = 97) by long-term follow up. UFC was first measured by automated chemiluminescence immunoassays (ADVIA Centaur, Siemens; LIAISON, DiaSorin). Aliquots of all samples were also analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Statistics: Passing-Bablok Regression, Receiver operating characteristic (ROC) analysis with Youden's index calculation. UFC of CS patients were higher with both immunoassays compared to LC-MS/MS (913 +/- 235 vs. 303 +/- 155 μg/24 h (ADVIA) and 898 +/-216 vs. 399 +/- 196 μg/24 h (LIAISON)). Similarly, UFC were higher with immunoassays than with LC-MS/MS in the control group (223 +/- 10 vs. 23 +/- 2 μg/24 h (ADVIA) and 105 +/- 6 vs. 27 +/- 4 ug/24 h for (LIAISON)). Passing-Bablok regression showed good correlation between LC-MS/MS and ADVIA as well as between LCMS/MS and LIAISON (r = 0.96 and r = 0.99, p 000.1) but less correlation in controls (r = 0.83 and r = 0.74, respectively, p 000.1). ROC calculation revealed the highest ROC AUC (0.89) for the LIAISON immunoassay, followed by LC-MS/MS (0.82) and the ADVIA (0.80). In direct comparison, AUCs from LC-MS/MS and immunoassays in the same patient were not statistically different (p 0,001). Best cut-off concentration to identify patients with CS was 234 μg/24 h (LIAISON), 51 μg/24 h for LC-MS/MS and 330 μg/24 h (ADVIA Centaur). In summary, UFC values were measured substantially higher by both immunoassays compared to LC-MS/MS. This is most likely due to cross-reactivity from interfering glucocorticoid metabolites. Nevertheless, all three methods correlated well. ROC analysis revealed the highest AUC for one of the immunoassays, although differences between the three methods were not significant. Direct comparison with LC-MS/MS indicates that high diagnostic accuracy can be obtained with suitable immunoassays.

Aims We investigated the dose–response association of 24-hour urine sodium and potassium with 24-hour ambulatory blood pressure. Design Cross-sectional community-based study. Methods Among the 1128 participants in the community-based cross-sectional survey, 740 participants (aged 20–70 years) with complete 24-hour urine collection and valid 24-hour ambulatory blood pressure monitoring were included in the study. Participants were grouped into younger (Results In the older population, nighttime blood pressure linearly increased with 24-hour urine sodium and the sodium to potassium ratio. For 24-hour urine sodium, adjusted β was 0.171 (95% confidence interval (CI) 0.036–0.305) for nighttime systolic blood pressure and 0.144 (95% CI 0.012–0.276) for nighttime diastolic blood pressure. For the 24-hour urine sodium to potassium ratio, adjusted β was 0.142 (95% CI 0.013–0.270) for nighttime systolic blood pressure and 0.144 (95% CI 0.018–0.270) for nighttime diastolic blood pressure. The 24-hour blood pressure linearly increased with the 24-hour urine sodium to potassium ratio and adjusted β was 0.133 (95% CI 0.003–0.262) for 24-hour systolic blood pressure and 0.123 (95% CI 0.003–0.244) for 24-hour diastolic blood pressure. Daytime blood pressure and 24-hour systolic blood pressure showed a significant but non-linear association with 24-hour urine sodium among the older population. In the younger population, 24-hour urine sodium, potassium and the sodium to potassium ratio were not associated with ambulatory blood pressure. Conclusion In the older population, 24-hour urine sodium and the sodium to potassium ratio showed a linear and positive association with nighttime blood pressure, and 24-hour urine sodium was associated with 24-hour systolic blood pressure and daytime blood pressure in a non-linear fashion.

Background: Nephrolithiasis is a worldwide health problem. Objectives This study investigated the frequency of urinary and serum metabolic abnormalities and their association with demographic characteristics in patients with nephrolithiasis. Methods: In this cross-sectional study, we assessed 376 patients with nephrolithiasis who referred to Motahari Medical Center, Shiraz from March 2017 to June 2017. Patients’ history, 24-hour urine analysis (for volume, calcium, uric acid, sodium, citrate, phosphate, and oxalate), and serum tests (for calcium, uric acid, and parathyroid hormone) were recorded in a data gathering sheet. P value < 0.05 was considered statistically significant. Results: The most common abnormality was a low volume of 24-hour urine (< 2000 mL), (73.7%), followed by hypercalciuria (23.9%), and hyperoxaluria (19.4%). Low 24-hour urine volume was more frequent in women (80.0% vs. 64.3%, P < 0.001), while hypercalciuria (37.0% vs. 18.3%, P < 0.001), and hyperphosphaturia (6.0% vs. 1.7%, P = 0.03) were more frequent in men. Moreover, hypercalciuria was more frequent in outdoor workers (39.7% vs. 21.1%, P = 0.003), whereas low urine volume was more frequent in indoor workers (79.0% vs. 61.1%, P = 0.006). Metabolic abnormalities were not different in terms of patients’ family history. Conclusions: Multiple factors affect the frequency and type of nephrolithiasis. Since these parameters are also influenced by race, culture, and dietary habits; thus each region must determine its own demographic features of renal stone. Based on our results, women had lower urine volume and higher urine citrate than men. Moreover, water intake is one of the most important factors that correlate with renal stone formation.

Introduction:Compliance with 24-hour urine collections for assessing kidney stone risk is important in assigning preventive therapy. We determined factors associated with compliance and the...

Introduction: Hypertensive disorder in pregnancy (HDP) is one of the most common medical complications affecting approximately 5-10% of pregnancies. It remains a major cause of maternal/perinatal mortality and morbidity. Proteinuria is a sign of preeclampsia where there is >300 mg of protein in 24 hour urine collection. This usually correlates with 30mg/dl or 1+ reading in a random urine specimen. The main objective of this study is to find out whether urine dipstick correlates with 24 hour urine protein. Methodology: This is a hospital based comparative study, where proteinuria by dipstick method was compared with 24 hour urinary protein in 60 cases of pre eclampsia at Paropakar Maternity and Women’s Hospital, Thapathali, Kathmandu. Results: The dipstick method of detecting proteinuria significantly correlated with the total 24 hour urine protein excretion by Esbach Albuminometer. A dipstick factor of ≥300mg/24 hour indicates proteinuria with sensitivity of 97.5%, specificity of 65%, positive predictive value of 84.78% and negative predictive value of 92.85%. 3+ value in dipstick had high significance with 24 hour urine protein by Esbach’s Albuminometer (R=0.983 ). The cost of dipstick was Nepalies Rs (NPR) 14 in comparison to 24 hour dipstick which cost NPR 80.Time needed to get report was immediate in case of dipstick but takes 48-50 hour in case of 24 hour urine protein. Conclusion: Timely collection of six hourly urine for detection of proteinuria by dipstick is comparable to 24 hour urinary protein determination in laboratory by Esbach Albuminometer, which is more time consuming and expensive.

The objective of this study was to determine the level of agreement between 3-day food records obtained as part of clinical care with 24-hour urine collections specifically assessing sodium, potassium, phosphorus, calcium, protein, and fluid intake.Data were collected from patients at a nephrology clinic in a metropolitan, academic medical center. Patients who completed both a 3-day food record and a 24-hour urine collection were analyzed. Food record and urine collection measurements were compared using a simple ratio, Pearson's correlation, and general linear models.Patients (n = 85) were 47.9 ± 15.2 years of age, 54% were female, with a mean serum creatinine of 1.3 ± 0.7 mg/dL and estimated glomerular filtration rate of 64.2 ± 25.6 mL/min. Patients had autosomal-dominant polycystic kidney disease (48.2%), nephrolithiasis (31.1%), chronic kidney disease (4.7%), or other genetic or cystic conditions impacting the kidney (12.9%). Nutrient intake was measured utilizing a 3-day food record. Food records and urine collections were compared using the values, correlations, and general linear models. Fluid intake demonstrated the highest agreement (ratio 1.01) and calcium demonstrated the least agreement (ratio 6.30). Significant correlations were demonstrated for phosphorus (r = 0.321, P = .003), magnesium (r = 0.256, P = .018), protein (r = 0.555, P .000), and fluid (r = 0.277, P = .010) intake. Food record intake of potassium (P = .046), protein (P = .004), and fluid (P = .010) were significant predictors of 24-hour urine excretion.3-day food records are useful tools to determine patient dietary patterns, but should be used with caution when assessing specific nutrient intake in clinical settings.

Background: Stone prevention is dependent on high fluid intake, with evidence that low urine volume (LUV) can promote nephrolithiasis in the absence of other metabolic abnormalities. Herein, we inv...

Many urinary biomarkers are adjusted for dilution using creatinine or specific gravity. The aim was to evaluate the variability of creatinine excretion, in 24 h and spot samples, and to describe an openly available variability biobank. Urine and blood samples were collected from 60 healthy non-smoking adults, 29 men and 31 women. All urine was collected at six time points during two 24 h periods. Blood samples were also collected twice and stored frozen. Analyses of creatinine in urine was performed in fresh urine using an enzymatic method. For creatinine in urine, the intra-class correlation (ICC) was calculated for 24 h urine and spot samples. Diurnal variability was examined, as well as association with urinary flow rate. The creatinine excretion rate was lowest in overnight samples and relatively constant in the other five samples. The creatinine excretion rate in each individual was positively correlated with urinary flow rate. The creatinine concentration was highest in the overnight sample and at 09:30. For 24 h samples the ICC was 0.64, for overnight samples it was 0.5, and for all spot samples, it was much lower. The ICC for urinary creatinine depends on the time of day of sampling. Frozen samples from this variability biobank are open for researchers examining normal variability of their favorite biomarker(s).