Investigating fluid intake in an underserved community: what factors are associated with low urine volume on 24-hour urine collection?

2021 ◽  
Author(s):  
Eric Ghiraldi ◽  
Alex Nourian ◽  
Michelle Chen ◽  
Justin Friedlander
Keyword(s):  
Fluid Intake ◽  
Urine Volume ◽  
Urine Collection ◽  
Underserved Community

scholarly journals False elevations in urinary metanephrines: under-recognised pitfall with 24-hour urinary volume collection

2021 ◽  
Vol 14 (2) ◽  
pp. e241147
Author(s):  
Terry Shin ◽  
Thanh Duc Hoang ◽  
Mary Thomas Plunkett ◽  
Mohamed K M Shakir
Keyword(s):  
African American Woman ◽  
Urine Volume ◽  
American Woman ◽  
Secondary Hypertension ◽  
Reference Laboratory ◽  
Urine Collection ◽  
Urinary Volume ◽  
Normal Limits ◽  
Incorrect Diagnosis ◽  
Urinary Metanephrines

One pitfall in 24-hour urine collection is the input of incorrect urinary volume by the reference laboratory. This may lead to an incorrect diagnosis of pheochromocytoma or paraganglioma. A 48-year-old African-American woman was seen in the clinic for an elevated 24-hour urine metanephrine screen during workup for secondary hypertension. Urine volume was found to be incorrectly inputted by the lab as 9750 mL rather than 975 mL. The urinary metanephrines were then recalculated and the 24-hour urinary metanephrines resulted within normal limits. This case highlights this unique and potentially under-recognised error in testing with 24-hour urine volume collection.

scholarly journals Effects of a 14-Day Hydration Intervention on Individuals with Habitually Low Fluid Intake

2021 ◽  
Author(s):  
Aaron R. Caldwell ◽  
Megan E. Rosa-Caldwell ◽  
Carson Keeter ◽  
Evan C. Johnson ◽  
François Péronnet ◽  
...  
Keyword(s):  
Body Weight ◽  
Total Body Water ◽  
Fluid Intake ◽  
Urine Volume ◽  
Urine Osmolality ◽  
Body Water ◽  
Control Group ◽  
Intervention Phase ◽  
Total Body ◽  
Experimental Group

<b><i>Background:</i></b> Debate continues over whether or not individuals with low total water intake (TWI) are in a chronic fluid deficit (i.e., low total body water) [<xref ref-type="bibr" rid="ref1">1</xref>]. When women with habitually low TWI (1.6 ± 0.5 L/day) increased their fluid intake (3.5 ± 0.1 L/day) for 4 days 24-h urine osmolality decreased, but there was no change in body weight, a proxy for total body water (TBW) [<xref ref-type="bibr" rid="ref2">2</xref>]. In a small (<i>n</i> = 5) study of adult men, there were no observable changes in TBW, as measured by bioelectrical impedance, after increasing TWI for 4 weeks [<xref ref-type="bibr" rid="ref3">3</xref>]. However, body weight increased and salivary osmolality decreased indicating that the study may have been underpowered to detect changes in TBW. Further, no studies to date have measured changes in blood volume (BV) when TWI is increased. <b><i>Objectives:</i></b> Therefore, the purpose of this study was to identify individuals with habitually low fluid intake and determine if increasing TWI, for 14 days, resulted in changes in TBW or BV. <b><i>Methods:</i></b> In order to identify individuals with low TWI, 889 healthy adults were screened. Participants with a self-reported TWI less than 1.8 L/day (men) or 1.2 L/day (women), and a 24-h urine osmolality greater than 800 mOsm were included in the intervention phase of the study. For the intervention phase, 15 participants were assigned to the experimental group and 8 participants were assigned to the control group. The intervention period lasted for 14 days and consisted of 2 visits to our laboratory: one before the intervention (baseline) and 14 days into the intervention (14-day follow-up). At these visits, BV was measured using a CO-rebreathe procedure and deuterium oxide (D<sub>2</sub>O) was administered to measure TBW. Urine samples were collected immediately prior, and 3–8 h after the D<sub>2</sub>O dose to allow for equilibration. Prior to each visit, participants collected 24-h urine to measure 24-h hydration status. After the baseline visit, the experimental group increased their TWI to 3.7 L for males and 2.7 L for females in order to meet the current Institute of Medicine recommendations for TWI. <b><i>Results:</i></b> Twenty-four-hour urine osmolality decreased (−438.7 ± 362.1 mOsm; <i>p</i> &#x3c; 0.001) and urine volume increased (1,526 ± 869 mL; <i>p</i> &#x3c; 0.001) in the experimental group from baseline, while there were no differences in osmolality (−74.7 ± 572 mOsm; <i>p</i> = 0.45), or urine volume (−32 ± 1,376 mL; <i>p</i> = 0.89) in the control group. However, there were no changes in BV (Fig. <xref ref-type="fig" rid="f01">1</xref>a) or changes in TBW (Fig. <xref ref-type="fig" rid="f01">1</xref>b) in either group. <b><i>Conclusions:</i></b> Increasing fluid intake in individuals with habitually low TWI increases 24-h urine volume and decreases urine osmolality but does not result in changes in TBW or BV. These findings are in agreement with previous work indicating that TWI interventions lasting 3 days [<xref ref-type="bibr" rid="ref2">2</xref>] to 4 weeks [<xref ref-type="bibr" rid="ref3">3</xref>] do not result in changes in TBW. Current evidence would suggest that the benefits of increasing TWI are not related changes in TBW.

CONSERVATIVE MANAGEMENT OF ACUTE RENAL FAILURE

PEDIATRICS ◽  
1960 ◽  
Vol 25 (3) ◽  
pp. 409-418
Author(s):  
S. A. Kaplan ◽  
J. Strauss ◽  
A. M. Yuceoglu
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Fluid Intake ◽  
Sodium Intake ◽  
Caloric Intake ◽  
Urine Volume ◽  
Proximal Tubules ◽  
Cation Exchange Resins ◽  
Exchange Resins ◽  
Insensible Loss

The observations during treatment of three children with acute renal failure by a conservative regimen of therapy are presented. One patient died. The regimen has also been applied to six adults with renal failure; one died. The urine in the early stages of renal failure may be iso-osmotic with plasma and may represent unmodified fluid from the proximal tubules. Cardiac failure associated with hyperkalemia or administration of excessive quantities of fluids is the most frequent cause of death in this disorder. A regimen of therapy is described which embodies the following principles: a) Limitation of daily fluid intake to insensible loss plus the urine volume of the previous day. b) Restriction of sodium intake from the beginning to anticipate the development of acidosis. c) Use of cation exchange resins to prevent excessive increase in the concentration of potassium in the serum. d) Provision of adequate caloric intake through the administration of emulsified fat intravenously. e) Treatment of hyperphosphatemia and hypocalcemia when they occur. f) Continuation of careful supervision and therapy, even after the diuretic phase begins, since renal function continues to be severely restricted for several days afterwards.

scholarly journals The impact of lower urinary tract symptomatology on urine volumes in stone formers

2018 ◽  
Vol 13 (8) ◽  
Author(s):  
Nathan Y. Hoy ◽  
Nick S. Dean ◽  
Jeremy Wu ◽  
Timothy A. Wollin ◽  
Shubha K. De
Keyword(s):  
Urinary Tract ◽  
Urine Output ◽  
Lower Urinary Tract ◽  
Urine Volume ◽  
Urine Collection ◽  
Inclusion Criteria ◽  
Stone Formers ◽  
Number Of Patients ◽  
The Impact ◽  
Lower Urinary

Introduction: We aimed to determine if there is a correlation between International Prostate Symptom scores (IPSS) and 24-hour urine collection volumes, as patients experiencing lower urinary tract symptoms (LUTS) may have impaired ability to increase fluid intake for stone prevention.Methods: We conducted a single-centre, retrospective review was performed of stone-formers presenting from 2014‒2016. Inclusion criteria were completion of an IPSS questionnaire and a 24-hour urine collection. Exclusion criteria included symptomatic stone or urinary tract infection at time of IPSS completion, inadequate 24-hour collection, or incomplete IPSS questionnaire.Results: A total of 131 patients met inclusion criteria. Stratification by IPSS severity into mild (0‒7), moderate (8‒19), and severe (20‒35) yielded groups of n=96, 28, and 7, respectively. Linear regression modelling did not reveal a correlation between IPSS score and volume (p=0.10). When compared to those with adequate urine volumes (>2 L/day, n=65), low-volume patients (<1 L/day, n=10) had a significantly higher total IPSS (11.7 vs. 6.1; p=0.036). These groups showed significant differences in their responses to questions about incomplete emptying (p=0.031), intermittency (p=0.011), and stranguria (p=0.0020), with higher scores noted in the low urine output group.Conclusions: This study is the first to examine the correlation between IPSS and 24-hour urine volume. Though our data does not show a linear relationship between urine output and IPSS, those with lower urine volumes appear to have worse self-reported voiding symptoms when compared to those with adequate volumes (>2 L/day) for stone prevention. The overall number of patients in our study is relatively small, which may account for the lack of a relationship between IPSS and 24-hour urine volumes.

scholarly journals Racial and Sex Differences in 24 Hour Urinary Hydration Markers among Male and Female Emerging Adults: A Pilot Study

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1068 ◽  
Author(s):  
William M. Adams ◽  
Derek J. Hevel ◽  
Jaclyn P. Maher ◽  
Jared T. McGuirt
Keyword(s):  
College Students ◽  
Emerging Adults ◽  
Fluid Intake ◽  
Urine Volume ◽  
Urine Osmolality ◽  
Urine Specific Gravity ◽  
Urine Color ◽  
Males And Females ◽  
Race Ethnicity ◽  
Hispanic White

The purpose of this study was to examine 24 h urinary hydration markers in non-Hispanic White (WH) and non-Hispanic Black (BL) males and females. Thirteen males (BL, n = 6; WH, n = 7) and nineteen females (BL, n = 16, WH, n = 3) (mean ± SD; age, 20 ± 4 y; height, 169.2 ± 12.2 cm; body mass, 71.3 ± 12.2 kg; body fat, 20.8 ± 9.7%) provided a 24 h urine sample across 7 (n = 13) or 3 (n = 19) consecutive days (148 d total) for assessment of urine volume (UVOL), urine osmolality (UOSM), urine specific gravity (USG), and urine color (UCOL). UVOL was significantly lower in BL (0.85 ± 0.43 L) compared to WH college students (2.03 ± 0.70 L) (p < 0.001). Measures of UOSM, USG, and UCOL, were significantly greater in BL (716 ± 263 mOsm∙kg−1, 1.020 ± 0.007, and 4.2 ± 1.4, respectively) compared to WH college students (473 ± 194 mOsm∙kg−1, 1.013 ± 0.006, 3.0 ± 1.2, and respectively) (p < 0.05). Differences in 24 h urinary hydration measures were not significantly different between males and females (p > 0.05) or between the interaction of sex and race/ethnicity (p > 0.05). Non-Hispanic Black men and women were inadequately hydrated compared to their non-Hispanic White counterparts. Our findings suggest that development of targeted strategies to improve habitual fluid intake and potentially overall health are needed.

scholarly journals A New Method to Make 24-Hour Urine Collection More Convenient: A Validity Study

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Pooneh Nabavizadeh ◽  
Shadi Ghadermarzi ◽  
Mohammad Fakhri
Keyword(s):  
Healthy Volunteers ◽  
Sampling Method ◽  
Urine Volume ◽  
New Method ◽  
Validity Study ◽  
Urine Collection ◽  
Protein Levels ◽  
Collection Device ◽  
Fixed Proportion ◽  
High Degree

Background and Objectives. This study proposes a novel urine collection device that can divide each urine collection into 20 parts and store and cool just one part. The aim of the current study is to compare measured biomarkers from the proposed urine collection device to those of conventional 24-hour sampling method. We also hypothesized that the new method would significantly increase patients’ adherence to the timed urine collection.Methods. Two 24-hour urine samples with the conventional method and with the new automated urine collection device that uses just one-twentieth of each void were obtained from 40 healthy volunteers. Urine parameters including volume, creatinine, and protein levels were compared between the two methods and the agreement of two measurements for each subject was reported through Bland-Altman plots.Results. Our results confirmed that for all three variables, there is a positive correlationP<0.001between the two measurements and high degree of agreement could be seen in Bland-Altman plots. Moreover, more subjects reported the new method as “more convenient” for 24-hour urine collection.Conclusions. Our results clearly indicate that a fixed proportion of each void may significantly reduce the urine volume in timed collections and this, in turn, may increase subjects’ adherence to this difficult sampling.

scholarly journals EFFECTS OF INDOMETHACIN ON FLUID INTAKE, URINE VOLUME URINARY PROSTAGLANDIN E-LIKE MATERIAL AND KALLIKREIN IN VASOPRESSIN RESISTANT DIABETES INSIPIDUS

1977 ◽  
Vol 11 (4) ◽  
pp. 433-433 ◽  
Author(s):  
Hulda J Wohltmann ◽  
Perry V Haluahka ◽  
Philip J Privitera ◽  
Harry S Margolius ◽  
Richard G Wagner ◽  
...  
Keyword(s):  
Diabetes Insipidus ◽  
Fluid Intake ◽  
Urine Volume ◽  
Prostaglandin E

scholarly journals Relationships Between Fluid Intake, Breast Milk Volume, and Urine Volume in Lactating Women

2015 ◽  
Vol 29 (S1) ◽  
Author(s):  
Amy McKenzie ◽  
Erica Perrier ◽  
Liliana Jimenez ◽  
Lawrence Armstrong
Keyword(s):  
Breast Milk ◽  
Fluid Intake ◽  
Urine Volume ◽  
Lactating Women ◽  
Milk Volume

Hyperhydration with glycerol solutions

1987 ◽  
Vol 63 (6) ◽  
pp. 2262-2268 ◽  
Author(s):  
M. L. Riedesel ◽  
D. Y. Allen ◽  
G. T. Peake ◽  
K. Al-Qattan
Keyword(s):  
Fluid Intake ◽  
Urine Volume ◽  
Plasma Osmolality ◽  
Blood Chemistry ◽  
Blood Samples ◽  
Male And Female ◽  
In Series ◽  
Multiple Blood ◽  
Female Subjects

Glycerol was tested as an agent to promote hyperhydration of male and female subjects. Series I experiments involved ingesting 0.5, 1.0, or 1.5 g glycerol/kg body wt and within 40 min drinking 0.1% NaCl, 21.4 ml/kg. In series II, 1.0 g glycerol/kg body wt was ingested at time 0, and 25.7 ml/kg of 0.1% NaCl was ingested over a 3.5-h period. Experiments were of 4-h duration and included controls without glycerol as each subject served as his/her control. Blood samples were taken at 40- or 60-min intervals for hemoglobin (Hb), hematocrit (Hct), plasma osmolality, glycerol, and multiple blood chemistry analyses. Urine was collected at 60-min intervals. Glycerol ingestion increased plasma osmolality for 2 h and reduced the total 4-h urine volume. There were no significant changes in Hb or Hct as a result of the glycerol or excess fluid intake. This study demonstrates that glycerol plus excess fluid intake can produce hyperhydration for at least 4 h.

scholarly journals Estimated Daily Urine Volume and Solute Excretion from Spot Urine Samples to Guide the Therapy of Hyponatremia in SIADH

2019 ◽  
Vol 8 (10) ◽  
pp. 1511 ◽  
Author(s):  
Decaux ◽  
Musch
Keyword(s):  
Urine Volume ◽  
Urine Osmolality ◽  
Urine Collection ◽  
Water Restriction ◽  
Spot Urine ◽  
Inappropriate Secretion ◽  
Spot Urine Sample ◽  
Daily Urine ◽  
Solute Excretion ◽  
Normal Controls

Background: In hyponatremia, due to the inappropriate secretion of antidiuretic hormone (SIADH), a high versus low solute intake will affect the urine volume (UV) and, hence, the SNa level. The clinical implication of the fractional solute excretion is presented. Methods: In 35 normal controls and 24 patients with SIADH and urine osmolality higher than serum osmolality, we compared exact solute intake obtained from 24 h urine collection, with the estimated value obtained on a urine morning spot sample by the formula: eGFR (L/min) × Sosm × 1440 × FE.Osm (%) = mmol/24 h. The exact UV was compared with the estimated value given by the formula: eGFR × 1440 × S.Creat/U.Creat (for eGFR the MDRD was used). In 65 patients with chronic SIADH, from which a morning spot urine sample was available, we determined the estimated fluid and solute intake. Results: A good correlation was observed between the measured solute output or urine volume and the estimated values obtained from the controls (r = 0.86) as well as in SIADH (r = 0.91). Conclusion: Patients with low solute intake (FE.Osm <1.4%) and low diuresis (V/eCcr <0.8%) should increase their intake by taking oral urea, for example. Patients with high solute intake (FE.Osm >2.5%) and high diuresis (V/eCcr >1.5%) could usually be treated by mild water restriction (< 1.5–21/24 h).

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