Dipstick urine analysis for detection of renal abnormalities among school children

Background: Urine analysis by dipstick is a useful tool to identify children with asymptomatic renal diseases.  Dipstick urinalysis screening was conducted in asymptomatic school children to detect prevalence of renal disease.Methods: A cross sectional study was carried out in 862 children of age 6 to 15 years studying in different schools of Birgunj, Nepal between January 2019 to June 2019. First morning mid-stream urine samples were obtained from students and tested by dipstick method. Children with abnormal findings were re-tested after fifteen days.Results: Ninety-six (11.13%) children had urinary abnormalities at the first screening; 8 children had specific urinary abnormalities after second screening. 4 children had urinary tract infection, followed by glomerulonephritis, type 1 diabetes, hydronephrosis and nephrotic syndrome. Urinary abnormalities were more common in females than in males.Conclusions: Asymptomatic urinary abnormalities are detected by urine screening program at school age. Further work-up reveals the specific diagnosis and effective interventions help reduce the renal disease in future.

Prevalence of asymptomatic bacteriuria among low risk pregnant women attending antenatal care clinic in tertiary hospital: a cross sectional study

Background: The current study aims to identify the prevalence of asymptomatic bacteriuria among low-risk pregnant women attending the antenatal care clinic of tertiary University Hospital and to detect the most common causative organisms.Methods: A prospective cross-sectional study conducted at a tertiary University Hospital in the period between 1st November 2017 and 31st June 2018. All eligible women attending the outpatient clinic for antenatal care were approached to participate in the study. The recruited women were assessed through detailed history and clinical examination. Urine samples were taken for culture and sensitivity within two hours, in order to avoid bacterial multiplication. Urine culture and antibiotic sensitivity test were done.Results: The study included 250 women. The mean age of included women was 25.89±5.49 (18-42 years). The urine analysis results showed that 32% of cases had pus cells >5 per high power field and 10.4% of cases have protein (+). Casts were present in 0.8% of cases. RBCs >5 per high power field were present in 4.8% of cases. ASB is defined as urine culture with more than 100,000 colony forming unit; this was present in 30 cases. This indicates that the prevalence of ASB among studied cases was 12%. Enterococcus was the most prevalent organism as it was present in 36.7% among positive cases. Antibiotic sensitivity test was performed to the growing organisms indicated that teicoplanin, imipenem, cefoxitin, cefotaxime + clavulanic acid, Entrapenem, and trimethoprim + sulfamethoxazole are the most effective antibiotics against the most common organisms causing asymptomatic bacteriuria.Conclusions: The prevalence of asymptomatic bacteriuria among low-risk pregnant women is about 12%. Urine culture for asymptomatic bacteriuria should be the standard of care for evaluation of pregnant patient during antenatal care as regard presence or absence of UTI.

Quantification of human urine aldosterone by LC-MS/MS / 中华检验医学杂志

Objective To establish a method for quantification of aldosterone (ALD) in urine by LC-MS/MS.Methods This study was the establishment and validation of methodology for urine ALD using LC-MS/MS.The urine samples were hydrolyzed at 37 ℃ by hydrochloric acid and the deuterated isotope internal was then added , followed by protein precipitation and anion exchange solid phase extraction (SPE). After SPE, the eluates were detected in the negative electro-spray ionization mode and multiple reaction monitor mode.The linearity, lower limits of quantification , precision and recovery of LC-MS/MS were evaluated.Urine and serum ALD of 80 subjects were measured by LC-MS/MS to evaluate the correlation of ALD detected in serum and 24 h urine.70 urine samples were collected and measured with LC-MS/MS and CLIA method for ALD comparison.14 participants were recruited to study the distribution of urine ALD in apparent healthy population .Results The analytical time was 4.5 min.Linearity of ALD was good in the range of 2-1 000 pg/ml (R2＞0.990); the repeatability and CV of ALD were less than 4.0% and 5.0%respectively; the recovery of urine ALD ranged between 100.4%and 108.2%; the lower limits of detection was 1 pg/ml.The correlation between urine and serum ALD was 0.396.The method comparison resulted in linear equation Y＝0.998 8X+0.046 4(r＝0.991).The distribution of urine ALD in apparent healthy subjects were 0.74-17.09 μg/24 h.Conclusion A reliable and specific LC-MS/MS method for urine ALD was established.And condition of the acid hydrolyzation for urine ALD was optimized .The method is simple, rapid and it can be used for the diagnosis of primary aldosteronism.

The performance evaluation of UW2000 automatic urine system / 国际检验医学杂志

Objective To evaluate the performance of UW2000 automatic urine system .Methods Using UW2000 automatic u‐rine system ,to evaluate intra ,inter batch precision ,linear ,carryover ,and the accuracy of the urine visible components(RBC ,WBC);at the same time intra ,inter batch precision and accuracy of of urine dry chemistry component .Results The within‐run coefficients of variation(CV% ) of RBC in high ,middle and low‐value samples were 15 .6% ,6 .8% ,20 .3% ,WBC were 16 .4% ,10 .5% ,24 .6% , respectively .Inter‐run precision of variation(CV% ) of RBC in middle and low‐value were 12 .8% ,13 .2% ,WBC were 15 .3% , 22 .8% ,respectively .The correlation coefficient of RBC was 0 .991 and the linear range was 88-19 513/μL .The correlation coeffi‐cient of WBC was 0 .997 and the linear range was 7-8 254/μL .And carryover rate was 0 .00% for RBC and 0 .06% for WBC ;The coefficient of UW2000 and microscopy on RBC and WBC were 0 .992 ,0 .995 .Within‐run precision ,inter‐run precision and accuracy for urine dry chemical composition of high ,low controls were all within the requirements of standards .Conclusion UW2000 auto‐matic urine analyzer workstation was not only save manpower ,but also with high detection speed and save cost .Importantly ,the re‐sults are reliability .In addition ,it could meet the working requirement in the general hospital ,and has great application value .

Urine examination for early diagnosis of neonatal multiple organ injury / 国际儿科学杂志

Neonatal visceral injury have high clinical incidence and it is hard to make clinical diagnosis early by routine inspection. In recent years,researches have shown that neonatal multiple organs damage can be diagnosed early by analyzing some special components in urine. Besides,urine analysis is a noninvasive examina-tion method and it is suitable for clinical promotion. This paper enumerates the application of neonatal urine ex-amination in the early diagnosis of kidney damage,bronchial pulmonary displasia,patent ductus arteriosus,hy-poxic ischemic encephalopathy and metabolic disease.

Urinary Screening for Detection of Renal Abnormalities in Asymptomatic School Children, Sohag Governorate, Egypt.

Background: Dipstick urine analysis is the most common method for screening children for detecting urinary abnormalities. This study is aimed to estimate the frequency of urinary problems among children aged 6-13 years from five primary schools in different parts of the Sohag Governorate, Egypt. Study Design and Setting: Cross-sectional study carried out by the Pediatrics Department and Community Medicine Departments at Sohag University, Egypt. Study Duration: Study was conducted during the academic year of Egypt 2014-2015. Methods: Urine analysis was performed for 2850 asymptomatic school children [1800 (63%) males and 1050 (37%) females]. Out of which, 1736 (61%) children were from rural areas and 1114 (39%) children were from urban areas. Microscopic examinations were performed for the abnormal dipstick samples after two weeks. Urine culture and other investigations were done to determine the underlining urinary abnormities. Results: The initial urinary screening by dipstick revealed 53 children (1.86%) had urine abnormities. Confirmatory test by complete microscopic examination of urine after 15 days showed that only 38 children (1.33%) still had urinary abnormalities. Twenty-one children (0.74%) had hematuria, three children (0.11%) had proteinuria and 14 children (0.49%) had pyuria. Urinary tract infections (UTIs) were diagnosed in 21 children (14 children with pyuria and seven children with hematuria) in whom further evaluation revealed UTIs. The most common bacteria in positive urine culture samples were gram-negative bacilli in 42.86% children. Conclusion: Small number of asymptomatic renal abnormalities can be detected by dipstick urine screening. The common abnormalities were hematuria, UTIs and proteinuria. Hematuria and UTIs were more common in females than males. Further work is needed to determine value of early detection of renal disorders in childhood in preventing development of end-stage renal diseases.

Long distance run induced hydration and kidney function changes in marathoners / Corrida de longa distância induz a mudanças no estado de hidratação e na função renal em maratonistas / Funcionamiento para un cambios de larga distancia inducido en el estado de hidratación y función renal en maratonistas

The aim of the study was to verify the hydration status and the kidney function in marathoners during the training season and after a marathon race. Nine male runners were investigated during 12 weeks of training. Urine was collected in four moments; in the beginning (C1) and during (C2) the training program, before (C3) and after (C4) the competition. Urine pH was measured using reagent tapes, urine density with a refractometer, protein excretion by Bradford assay and erythrocytes and leucocytes by microscopy. Changes were observed when C-4 was compared to the other collection times for all variables investigated. It is possible to conclude that physical exertion induced important changes in the hydration status and glomerular membrane selectivity to macromolecules, modifying the kidney function of the marathoners in C4.

O objetivo do estudo foi verificar o estado de hidratação e a função renal de maratonistas durante uma temporada preparatória e após a competição. Foram estudados nove maratonistas durante 12 semanas de treinamento. A urina foi coletada em quatro momentos: antes (C1) e durante (C2) o protocolo de treinamento, antes (C3) e após (C4) a competição. Foram mensurados o pH a partir de tiras de reagentes, a densidade por meio do refratômetro, a proteinúria pelo ensaio de Bradford, concentração de eritrócitos e de leucócitos por microscopia. Alterações foram encontradas quando comparado o C-4 com as coletas anteriores para todas as variáveis estudadas. Pode-se concluir que o exercício físico induziu a modificações importantes no estado de hidratação dos corredores e na função da membrana glomerular, modificando assim, a função renal dos maratonistas no momento pós prova.

El objetivo del estudio fue determinar el estado de hidratación y la función renal en los corredores de maratón durante una temporada de preparación y después de la competición. Se estudiaron nueve corredores durante 12 semanas de entrenamiento. La orina se recogió en cuatro momentos: antes y durante el protocolo de entrenamiento, antes y después de la competición. PH de tiras reactivas, de densidad a través del refractómetro, proteinuria por Bradford ensayo, concentración de eritrocitos y leucocitos fueron medidos por microscopía. No se encontraron cambios al comparar el C-4 con las colecciones anteriores para todas las variables. Se puede concluir que el ejercicio induce cambios significativos en el estado de hidratación de los corredores y la función de la membrana glomerular, modificando de este modo la función renal del tiempo de maratón después de la carrera.

Evaluation of a Test Index Obtained by Coupling Protein with Specific Gravity of Screening Urine Test

BACKGROUND: The 24-hr urine protein excretion test is regarded as a standard for quantitative urinary protein analysis; however, collection of urine over 24 hr is troublesome and errors may occur during the process. We obtained a test index reflecting diluted or concentrated urine by coupling the results of a simple and rapid routine urine analysis and evaluated its usefulness as a marker that quantitatively reflects the 24-hr urine protein excretion. METHODS: The estimated urine protein-osmolality ratio (Pro/Osm) was obtained by two linear regression equations between urine dipstick protein and natural logarithm of the protein concentration, and between urine specific gravity (SG) and urine osmolality (Osm). Sensitivity and specificity of 'estimated urine Pro/Osm' and the widely used urine protein-creatinine ratio were evaluated for their efficiency in diagnosing pathological proteinuria and nephrotic proteinuria based on 24-hr urine protein excretion. RESULTS: Moderate correlations were noted between protein concentration determined by the urine dipstick protein assay and natural logarithm of protein concentration (r=0.86) and between urine SG and urine Osm (r=0.74). The receiver operating characteristics analysis showed that an estimated urine Pro/Osm value of 0.045 had a sensitivity of 91.1% and a specificity of 88.6% for diagnosing pathological proteinuria, and a value of 0.204 had a sensitivity of 100% and a specificity of 80.4% for diagnosing nephrotic proteinuria. CONCLUSIONS: Coupling the results of urine dipstick protein and urine SG determined by the routine analysis will provide additional useful information that will make the screening of renal diseases more cost-effective.

Análisis de orina: estandarización y control de calidad / Urine analysis: standardization and quality control / Análise de urina: padronização e controle de qualidade

El examen de orina completa data de los tiempos de Hipócrates. En la actualidad se basa en la utilización de tiras reactivas y la visualización al microscopio, careciendo de una estandarización actualizada y control de calidad. En el presente trabajo se realizó un estudio comparativo entre observadores, estandarizando el proceso y elaborando una solución control junto con una colección fotográfica del sedimento para enseñanza, entrenamiento y control interno. Se evaluaron 200 muestras de orinas de pacientes al azar. Los parámetros fisicoquímicos se determinaron en un equipo Urisys 2400 (Roche). El análisis microscópico fue realizado por dos operadores experimentados. Se preparó una solución control positiva de los parámetros usuales de tiras reactivas. Los resultados fueron analizados mediante el test Kappa, p<0,05. La correlación entre observadores, utilizando el procedimiento propuesto, fue siempre mayor que con el proceso de rutina. La solución control fue estable durante los 4 meses que duró la experiencia, dando positivas las determinaciones de glucosa, proteínas, hemoglobina, cetonuria y leucocitos, manteniéndose el valor de pH y de densidad. Se concluye que con la estandarización se logró aumentar el grado de correlación entre observadores, por lo tanto se propone el uso de esta metodología para uniformar criterios; además, la preparación de la sustancia control y de una colección fotográfica permitió controlar el procedimiento de una forma más económica sin dejar de lado la confiabilidad.

Urine analysis is one of the most ancient tests. It dates back from Hyppocrates times. Nowadays it is based on the use of reactive dipsticks and visual examinations in the microscope, with no quality control or adjusted standardization. In the present work, a standardized procedure, a positive control solution for dipsticks and a photographic collection of urine sediment were performed for teaching, training and control of the laboratory staff. Urisys 2400 (ROCHE) was used to analyze 200 samples randomly. The microscopic analysis was made by two experienced operators. A positive control solution of usual parameters of reactive dipsticks was performed. Data analysis was fulfilled by Kappa test p<0.05. The correlation between observers, using the proposed procedure, was always higher than in the routine process. The control solution was stable over the 4-month experience, yielding positive results in glucose, protein, hemoglobin, ketonuria and leukocyte, keeping pH and density values. It can be concluded that with standardization, the degree of correlation between observers was increased, for which reason this methodology is proposed to unify criteria; besides, elaboration of the control substance and a photographic collection makes it possible to control the procedure in a more economic fashion without leaving aside reliability.

O exame de urina completa data dos tempos de Hipócrates. Atualmente é baseado no uso de tiras-teste e a visualização no microscópio, carecendo de uma padronização atualizada e controle de qualidade. No presente trabalho foi realizado um estudo comparativo entre observadores padronizando o processo e elaborando uma solução de controle juntamente com uma coleção de fotografias do sedimento para ensino, treinamento e controle interno. 200 amostras de urinas de pacientes selecionados aleatoriamente foram avaliadas. Os parâmetros físico-químicos foram determinados em um equipamento Urisys 2400 (Roche). A análise microscópica foi realizada por dois operadores experientes. Foi realizada uma solução controle positiva dos parâmetros usuais de tiras-teste. Os resultados foram analisados através do teste Kappa, p<0,05. A correlação entre observadores, utilizando o procedimento proposto, foi sempre maior que com o processo de rotina. A solução controle manteve-se estável durante os 4 meses em que foi levada a cabo a experiência, dando positivas as determinações de glicose, proteínas, hemoglobina, cetonúria e leucócitos, mantendo o valor de pH e de densidade. Conclui-se que com a padronização foi possível aumentar o grau de correlação entre observadores, portanto se propõe o uso desta metodologia para uniformizar critérios; além disso, a elaboração da substância controle e de uma coleção fotográfica permite controlar o procedimento de uma maneira mais econômica, sem deixar de lado a confiabilidade.

Study on consistency of urinary sediment analyzer,urine dry chemistry analyzer and optical microscope in detecting urine erythrocyte / 国际检验医学杂志

Objective To analyze the consistency of the SYSMEX UF1000i automatic urinary sediment analyzer,Arkray AX-4030 urine dry chemistry analyzer and optical microscope in detecting urine erythrocyte.Methods The fresh urine specimens from 427 patients were randomly extracted and tested by the SYSMEX UF1000i automatic urinary sediment analyzer,urine dry chemistry analyzer and OLUMPUS Arkray AX-4030 optical microscope.Then the consistency of the results for detecting urine erythrocyte was compared among three kinds of detection method.Results With the microscopic examination as control,the sensitivity and spe-cificity of the SYSMEX UF1000i automatic urinary sediment analyzer for detecting urine erythrocyte were 82.84% and 86.35% re-spectively,which of the Arkray AX-4030 urine dry chemistry analyzer were 89.55% and 83.96% respectively.There was a high consistency between the SYSMEX UF1000i automatic urinary sediment analyzer and the optical microscope for detecting urine e-rythrocyte and the Kappa value was 0.580.There was also a high consistency between the Arkray AX-4030 urine dry chemistry analyzer and the optical microscope for detecting urine erythrocyte and the Kappa value was 0.625,while the consistency between the SYSMEX UF1000i automatic urinary sediment analyzer and the Arkray AX-4030 urine dry chemistry analyzer was weaker and the Kappa value was 0.324.Conclusion With the detection by the SYSMEX UF1000i automatic urinary sediment analyzer and the Arkray AX-4030 urine dry chemistry analyzer as a screening test,it should need to combine with the optical microscopy to conduct recheck for providing the effective and reliable test results quickly and accurately.

Results analysis of urine cellular components tested by Urit-1500 urine analyzer / 国际检验医学杂志

Objective To explore the clinical accuracy of urine cellular components of RBC,WBC,etc.detected by the Urit-1500 urine analyzer.Methods 1 085 urine samples in this hospital from June to October 2013 were selected and detected by the Urit-1500 urine analyzer and the microscope detection respectively.The results of urine cellular components detected by the urine analy-zer were analyzed.Results In 1 085 urine samples,the coincidence rate of two detection methods in detecting RBC and WBC was 93.8%(1 018/1 085)and 94.0%(1 020/1 085)respectively.In 295 RBC positive urine samples tested by the urine analyzer,the number of negative results tested by microscopy was 49,accounting for 16.6%.In 790 RBC negative urine samples tested by the u-rine analyzer,the number of negative results tested by microscopy was 18,accounting for 2.3%.In 197 WBC positive urine samples tested by urine analyzer,the number of negative results tested by microscopy was 28,accounting for 14.2%.In 888 WBC negative urine samples by urine analyzer,the number of negative results tested by microscopy was 37,accounting for 4.2%.Conclusion De-tecting urine RBC and WBC by using the Urit-1500 urine analyzer should combined with the microscopy and other test indexes and even clinical data to conduct the comprehensive analysis for reducing the misdiagnosis and missed diagnosis as far as possible.

Application evaluation of HC-900 urine analyzer for rapidly screening urine microalbumin / 国际检验医学杂志

Objective To evaluate the clinical application value of the HC-900 fully automated urine dry chemistry analyzer and its matched test strip (HC-900 analysis system) for detecting urine microalbumin (U-mAlb) .Methods 660 urine samples were collected with the negative urine protein detected by the HC-900 analysis system as the standard ,among them ,159 samples with positive U-mAlb screened by the test strip and 106 samples with the partial negative were performed the quantitative analysis by the Immage 800 fully automatic specific protein analyzer for verifying the results screened by the HC-900 analysis system .The compari-son of the U-mAlb quantitative detection results between the screening positive group and the screening negative group adopted the two samples rank sum test .The comparison between the enumeration data was carried out by Kappa test for consistency .Results Among 660 samples ,159 samples with positive U-mAlb were quantitatively detected by the Immage 800 analyzer and 101 samples were confirmed positive U-mAlb with the real positive rate of 63 .5% .Among 106 samples of negative U-mAlb randomly extracted by the HC-900 analysis system ,9 samples were confirmed to be positive U-mAlb quantitatively detected by the Immage 800 analy-zer .By the consistency test ,the difference between the two methods had statistical significance (Kappa=0 .495 ,P<0 .01) .The U-mAlb level was 18 .02(8 .23-34 .89)mg/L in the screening positive group ,which was significantly higher than 4 .78(2 .51-8 .46) mg/L in the screening negative group ,the difference had statistical significance (Z= -8 .689 ,P<0 .01) .Relative to the detection by the Immage 800 quantitative analyzer ,the sensitivity and specificity of the U-mAlb for the rapid screening by the dry chemistry method was 91 .8% (101/110) and 62 .5% (97/155) respectively .Conclusion The HC-900 analysis system for screening U-mAlb has a certain clinical application value .

Analysis of chlorpheniramine in human urine samples using dispersive liquid-liquid microextraction combined with high-performance liquid chromatography

A simple and environmentally friendly microextraction technique was used for determination of chlorpheniramine (CPM), an antihistamine drug, in human urine samples using dispersive liquid-liquid microextraction (DLLME) followed by high performance liquid chromatography with diode array detection (HPLC-DAD). In this extraction technique, an appropriate mixture of acetonitrile (disperser solvent) and carbon tetrachloride (extraction solvent) was rapidly injected into the urine sample containing the target analyte. Tiny droplets of extractant were formed and dispersed into the sample solution and then sedimented at the bottom of the conical test tube by centrifugation. Under optimal conditions, the calibration curve was linear in the range of 0.055-5.5 µg mL-1, with a detection limit of 16.5 ng mL-1. This proposed method was successfully applied to the analysis of real urine samples. Low consumption of toxic organic solvents, simplicity of operation, low cost and acceptable figures of merit are the main advantages of the proposed technique.

Utilizou-se uma técnica de microextração simples e ambientalmente amigável para a determinação de clorfeniramina (CPM), anti-histamínico, em amostras de urina humana, utilizando a microextração dispersiva líquido-líquido (DLLME), seguida por cromatografia líquida de alta eficiência com detecção por arranjo de diodos (HPLC-DAD). Nesse método de extração, mistura apropriada de acetonitrila (solvente dispersor) e tetracloreto de carbono (solvente de extração) foi injetada rapidamente na amostra de urina contendo o analito alvo. As pequenas gotículas de agente de extração foram formadas e dispersas na solução da amostra e, em seguida, sedimentadas no fundo do tubo cônico de ensaio por centrifugação. Em condições ótimas, a curva de calibração foi linear no intervalo entre 0,055 e 5,5 µg mL-1, com limite de detecção de 16,5 ng mL-1. O método proposto foi aplicado com sucesso na análise de amostras de urina reais. Baixo consumo de solventes orgânicos tóxicos, simplicidade de operação, baixo custo e figuras de mérito aceitáveis são as principais vantagens do método sugerido.

Diferenca de ions fortes na urina como determinante importante das alteracoes na concentracao plasmatica de cloreto em pacientes no pos-operatorio / Urinary strong ion difference is a major determinant of plasma chloride concentration changes in postoperative patients

OBJETIVO: Demonstrar que alterações na concentração plasmática de cloreto ([Cl-]plasma) durante o período pós-operatório são amplamente dependentes da diferença de íons fortes urinária ([SID]urina=[Na+] urina+[K+] urina -[Cl-]urina) e não de diferenças na terapia hídrica. MÉTODOS: Foram realizadas mensurações na admissão à unidade de terapia intensiva e 24 horas mais tarde em um total de 148 pacientes pós-operatórios. Os pacientes foram designados para um de três grupos segundo a alteração na concentração plasmática de cloreto após 24 horas: [Cl-]plasma aumentada (n=39), [Cl-]plasma diminuída (n=56) ou [Cl-]plasma inalterada (n=53). RESULTADOS: Quando da admissão, o grupo com [Cl-]plasma aumentada tinha [Cl-]plasma mais baixa (105±5 versus 109±4 e 106±3mmol/L; p<0,05), um ânion gap plasmático ([AG]plasma) mais alto e um íon gap forte mais alto. Após 24 horas, o grupo com [Cl-]plasma aumentada mostrou [Cl-]plasma mais alta (111±4 versus 104±4 e 107±3mmol/L; p<0,05) e nível plasmático mais baixo de [AG]plasma e íon gap forte. O volume e íon gap forte dos fluidos administrados foram similares entre os grupos, exceto que os [SID]urina eram mais altos (38±37 versus 18±22 e 23±18mmol/L; p<0,05) no grupo com [Cl-]plasma aumentada na avaliação após 24 horas. Uma análise de regressão linear múltipla demonstrou que a [Cl-]plasma na admissão e [SID]urina eram preditores independentes de variação na [Cl-]plasma 24 horas mais tarde. CONCLUSÕES: Alterações na [Cl-]plasma durante o primeiro dia pós-operatório foram amplamente relacionadas com [SID]urina e [Cl-]plasma na admissão, e não às características ...

OBJECTIVE: To show that alterations in the plasma chloride concentration ([Cl-]plasma) during the postoperative period are largely dependent on the urinary strong ion difference ([SID]urine=[Na+]urine+[K+]urine-[Cl-]urine) and not on differences in fluid therapy. METHODS: Measurements were performed at intensive care unit admission and 24 hours later in a total of 148 postoperative patients. Patients were assigned into one of three groups according to the change in [Cl-]plasma at the 24 hours time point: increased [Cl-]plasma (n=39), decreased [Cl-]plasma (n=56) or unchanged [Cl-]plasma (n=53). RESULTS: On admission, the increased [Cl-]plasma group had a lower [Cl-]plasma (105±5 versus 109±4 and 106±3mmol/L, p<0.05), a higher plasma anion gap concentration ([AG]plasma) and a higher strong ion gap concentration ([SIG]). After 24 hours, the increased [Cl-]plasma group showed a higher [Cl-]plasma (111±4 versus 104±4 and 107±3mmol/L, p<0.05) and lower [AG]plasma and [SIG]. The volume and [SID] of administered fluids were similar between groups except that the [SID]urine was higher (38±37 versus 18±22 and 23±18mmol/L, p<0.05) in the increased [Cl-]plasma group at the 24 hours time point. A multiple linear regression analysis showed that the [Cl-]plasma on admission and [SID]urine were independent predictors of the variation in [Cl-]plasma 24 hours later. CONCLUSIONS: Changes in [Cl-]plasma during the first postoperative day were largely related to [SID]urine and [Cl-]plasma on admission and not to the characteristics of the infused fluids. Therefore, decreasing [SID]urine could be a major mechanism for preventing the development of salineinduced hyperchloremia. .

The reasons of false-negative results in urine analysis and its improvement measures / 中国基层医药

Objective To explore the reasons of false-negative results in urine analysis and improvement measures.Methods Fresh morning urine specimen of 1 080 cases from January 2012 to March 2012 in our hospital were selected,and they were determined by dry chemical and sediment microscopic examination,then the results were compared between the two methods.Results 713 cases of white blood cells and 748 cases of red blood cells showed negative results by dry chemical method,while 692 cases of white blood cells and 723 cases of red blood cells showed negative results by sediment microscopic examination;The false negative rate of red blood cells and white blood cells by two methods were 2.95％,3.34％,the test results of the two methods showed no significant differences(x2 =0.900,1.330,all P ＞ 0.05).Conclusion The urine analysis should combine with dry chemical method and artificial microscopic urine analysis to improve the precision and accuracy of the test results,and to oliminate interference factors for avoiding undetected false detection.

Effect of α1-microglobulin and β2-microglobulin on calcium oxalate urine stone formation / 中华泌尿外科杂志

ObjectiveTo define the difference of urine analysis result,α1-microglobulin (α1-MG) and β2-microglobulin ( β2-MG) between those patients suffering from calcium oxalate stone,non-calcium oxalate stone and non-urolithiasis controls at the same time period.MethodsData from 100 patients admitted to the Department of Urology,First Affiliated Hospital of Anhui Medical University from July,2010 to September,2010 were reviewed.66 patients (45 men,21 women) suffered from urolithiasis,and 34 patients (22 men,12 women) were non-urolithiasis.Patients' ages in urolithiasis group varied from 13 to 78 years and the male to female ratio was 2.1∶1.0.The patients in non-urolithiasis controlgroup aged from 12 to 80 years and the male to female ratio was 1.8∶1.0.Blood and urine were taken from the patient the next morning after admission.The biochemistry from blood and 24 h urine were measured by automatic biochemistry analyzer.The α 1-MG and β2-MG content were measured by radioimmunoassay.The stone compositions were analyzed by infrared spectroscopy.ResultsThere was difference in the levels of serum creatinine and blood urea nitrogen among three groups ( P ＜ 0.05).In controls,those with calcium oxalate stone had higher level of urinary α1-MG and β2-MG,but there were no differences in the urinary electrolyte levels.Group of non-calcium oxalate stones urinary uric acid levels were higher than calcium oxalate and control groups,the difference was statistically significant.ConclusionsIn the formation of uric acid stones,uric acid increased as independent risk factors.α1-MG,β2-MG may promote the formation of calcium oxalate stones.

Estimation of Sodium Intake of Adult Female by 24-Hour Urine Analysis, Dietary Records and Dish Frequency Questionnaire (DFQ 55)

This study assesses the sodium intake of adults by 24-hour urine analysis, dietary records review and a food intake questionnaire. Subjects were 236 adult female in Daegu. The results are summarized as follows: Sodium intake as indicated by the 24-hour urine analysis was 5,805.4 +/- 3836.8 mg. This was significantly higher than intake indicated by dietary records (4415.4 +/- 1935.1 mg) and the dish frequency questionnaire (DFQ 55)(4293.5 +/- 1526.5 mg). The results of the 24-hour urine analysis and DFQ 55 showed that sodium intake was higher for the 65-to-74-year-old age group than for other age groups (p < 0.05, p < 0.05). Review of dietary records to examine typical sodium intake by food groups showed that 53.7% of the sodium consumed by subjects in all age groups came from seasonings and spices (2399.0 +/- 1526.5 mg). The analysis of sodium intake by food groups using DFQ 55 showed 34.2% of their sodium came from consumption of kimchi (p < 0.001) and kimch, soup, stew and fish jorim accounted for 57.8% of total sodium intake. The results indicate positive correlation between age and sodium intake, as shown by the 24-hour urine analysis and food intake questionnaire (p < 0.05). Therefore, these results would be valuable as basic data for planning nutrition education for sodium intake reduction.

Sodium Intakes of Korean Adults with 24-hour Urine Analysis and Dish Frequency Questionnaire and Comparison of Sodium Intakes According to the Regional Area and Dish Group / 대한지역사회영양학회지

This study was performed to assess the sodium intakes of Korean adults using a 24-hr urine analysis and dish frequency questionnaire (DFQ) according to each dish group and the regional area. The subjects of this study were comprised of 552 adults (male: 267, female: 285), aged 20-59yr residing in the metropolitan area (N = 200), Chungcheng-Do (N = 117), Jeolla-Do (N = 117), and Gueongsang-Do provinces (N = 118). The subjects were recruited from the residents who once participated or are participating in the various health programs offered by the public health center. The number of subjects who completed the 24-hr urine collection was 205 (male : 110, female : 95).The mean age and BMI of the subjects were 39.0+/-11.7 y and 23.1+/-2.9 kg/m2, respectively. The mean systolic and diastolic blood pressure was 119.5+/-15.4 mmHg, and 77.1+/-11.1 mmHg, respectively. Eighteen percent of the subjects responded that they are currently smoking, 36% drinking and 50.4% exercising. Twenty point six percent of the subjects were assessed as having hypertension according to their systolic or diastolic blood pressure(SBP > or = 140 mmHg or DBP > or = 90 mmHg) measurements in the present study. Salt intake of the subject estimated with 24-hr sodium excretion was 12.7 g/d (male : 13.4 g/d, female : 12.1 g/d) based on the sodium excretion rate as 82%. Salt intake estimated with DFQ was 14.7 g/d (male : 16.2 g/d, female : 13.4 g/d), 2 g more than the salt intake estimated with 24-hr urine analysis. The four dish groups that contributed most to the sodium intake in order were kimchi (I1571.4mg), soup and stew (1260.5 mg), fish and shellfish (706.3 mg) and noodle and ramyeon (644.3mg). Salt intake estimated with DFQ was the highest in the subjects of Gueongsang-Do (17.0 g/d), second highest Chungcheong-Do (16.4 g/d) and the lowest in the metropolitan area (13.0 g/d). Subjects of Gueongsang-Do showed the highest sodium intakes in most of the dish group, whereas subjects of the metropolitan area showed the lowest. Residents of Chuncheong-Do revealed the highest sodium intake with kimchi and ofJeolla-Do the higher sodium intake with the main dish (meat, fish and beans). The highest salt percentage of kimchi (3.0+/-0.8%) and soybean paste (14.5 +/-5.1%) were observed in Gueongsang-Do, whereas individuals of the metropolitan area were observed as having kimchi (1.6 +/-0.5%) and soybean paste (7.4 +/-1.6%) with the lowest salt percentage. Men were observed as having more salty kimchi (2.4 +/-0.1%) than women (2.1 +/-0.1%).

Development and Evaluation of Validity of Short Dish Frequency Questionnaire (DFQ) for Estimation of Habitual Sodium Intake for Korean Adults / 대한지역사회영양학회지

The aim of this study was to develop various types of a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and to evaluate the validity of a 125 item dish frequency questionnaire (DFQ 125) with the DFQ 70, DFQ 36 and DFQ 15. For the DFQ 125, one hundred and twenty five dish items were selected based on the information of sodium content of a one serving size, consumption frequency and dish items that contributed most to the variation of sodium intake. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. The sodium intake estimated with DFQ 125 was 5775.0 +/- 3636.3mg, 12.6% higher than that estimated with a 24 hr urine analysis (5009.7 +/- 1541.9mg) and significant correlation was observed between them (r = 0.3315, p < 0.001). When sodium content in broth leftover was subtracted from the total intake, the actual sodium intakes was decreased to 5309.6 +/- 3076.6mg, which was 3.2% higher than that with a 24-hr urine analysis. Overall, 56% of subjects in the lowest quintile of sodium intake computed with DFQ 125 were also in the lowest of adjacent quintile while categorization into the opposite quintile were 4.9%. DFQ 70 was developed from DFQ 125 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. The sodium intake estimated with DFQ 70 (5026.6 +/- 3107.1mg) showed only 0.2% difference from that estimated with a 24-hr urine analysis, significant correlation with it (r = 0.3199, p < 0.001) and higher proportion of subjects to be classified into the same or adjacent quintile. The sodium intake estimated with DFQ 36 or DFQ 15 was also significancy correlated with that estimated with a 24-hr urine analysis (r = 0.3441, p < 0.001; r = 0.321, p < 0.001 respectively) and more. The proportion of subjects was classified into the same or adjacent quintile. However, the actual sodium intake estimated with DFQ 36 or DFQ 15 were 3534.0 +/- 1804.6mg and 2508.0 +/- 1261.5mg, respectively, 31.3% or 51.3% less than that estimated with a 24-hr urine analysis. It seems the DFQ 125 with subtraction of sodium content in broth leftover or DFQ 70 can be used quantitatively to estimate sodium intake of adults. DFQ 36 or DFQ 15 can be used as a screening tool or to assess the changes of sodium intake after nutrition education.

Development and Evaluation of Validity of Dish Frequency Questionnaire (DFQ) and Short DFQ Using Na Index for Estimation of Habitual Sodium Intake / 대한지역사회영양학회지

The assessment of sodium intake is complex because of the variety and nature of dietary sodium. This study intended to develop a dish frequency questionnaire (DFQ) for estimating the habitual sodium intake and a short DFQ for screening subjects with high or low sodium intake. For DFQ112, one hundred and twelve dish items were selected based on the information of sodium content of the one serving size and consumption frequency. Frequency of consumption was determined through nine categories ranging from more than 3 times a day to almost never to indicate how often the specified amount of each food item was consumed during the past 6 months. One hundred seventy one adults (male: 78, female: 93) who visited hypertension or health examination clinic participated in the validation study. DFQ55 was developed from DFQ112 by omitting the food items not frequently consumed, selecting the dish items that showed higher sodium content per one portion size and higher consumption frequency. To develop a short DFQs for classifying subjects with low or high sodium intakes, the weighed score according to the sodium content of one protion size was given to each dish item of DFQ25 or DFQ14 and multiplied with the consumption frequency score. A sum index of all the dish items was formed and called sodium index (Na index). For validation study the DFQ112, 2-day diet record and one 24-hour urine collection were analyzed to estimate sodium intakes. The sodium intakes estimated with DFQ112 and 24-h urine analysis showed 65% agreement to be classified into the same quartile and showed significant correlation (r = 0.563 p < 0.05). However, the actual amount of sodium intake estimated with DFQ112 (male: 6221.9 mg, female: 6127.6 mg) showed substantial difference with that of 24-h urine analysis (male: 4556.9 mg, female: 5107.4 mg). The sodium intake estimated with DFQ55 (male: 4848.5 mg, female: 4884.3 mg) showed small difference from that estimated with 24-h urine analysis, higher proportion to be classfied into the same quartile and higher correlation with the sodium intakes estimated with 24-h urine analysis and systolic blood pressure. It seems DFQ55 can be used as a tool for quantitative estimation of sodium intake. Na index25 or Na index14 showed 39~50% agreement to be classified into the same quartile, substantial correlations with the sodium intake estimated with DFQ55 and significant correlations with the sodium intake estimated with 24-h urine analysis. When point 119 for Na index25 was used as a criterion of low sodium intake, sensitivity, specificity and positive predictive value was 62.5%, 81.8% and 53.2%, respectively. When point 102 for Na index14 was used as a criterion of high sodium intake, sensitivity, specificity and positive predictive value were 73.8%, 84.0%, 62.0%, respectively. It seems the short DFQs using Na index14 or Na index25 are simple, easy and proper instruments to classify the low or high sodium intake group.