Sodium and potassium intake was assessed on the basis of its respective excretion levels in 24 hr urine samples. However, owing to the inconvenience of collection, we evaluated random spot urine for alternative sodium and potassium excretion markers. We included 250 patients who submitted 24 hr- and spot urine for clinical tests. However, 22 patients who showed 24 hr urine creatinine excretion levels <500 mg/day were excluded, because these samples possibly resulted from incomplete urine collection. Moreover, 24 patients were excluded because of their use of diuretics during the urine collection period. We observed significant correlations between 24 hr urine sodium excretion and both the sodium/creatinine (r=0.34, P<0.0001) and the sodium/specific gravity unit (SGU) ratios (r=0.19, P=0.007) in random urine samples. Similarly, 24 hr urine potassium excretion and both the spot urine potassium/creatinine (r=0.47, P<0.0001) and potassium/SGU ratios (r=0.28, P<0.0001) were significantly correlated. Although the estimated sodium/creatinine and potassium/creatinine ratios showed a significant correlation with 24 hr urine sodium and potassium excretion, respectively, further studies are required to develop a spot urine test for individualized monitoring of sodium and potassium excretion.
Biomarkers/urine ; Creatinine/*urine ; Humans ; Hypertension/pathology/urine ; Potassium/*urine ; Sodium/*urine ; Urinalysis ; Urine Specimen Collection

BACKGROUND: Microalbuminuria is the main parameter used in diabetic patients for clinical evaluation of early diabetic nephropathy and other complications. The most common method for quantitative urinary protein relies on a 24-hour urine collection or overnight urine collection; however, this method is time consuming and sometimes obtains inaccurate results. This study is aimed to test whether the microalbumin to creatinine ratio (Uma/Ucr) in the first-morning urine samples correlates with the microalbumin content in the 24-hour urine collection. METHODS: 59 urine samples from 59 type 2 diabetic patients were analyzed for Uma/Ucr, and for 24-hour urine microalbumin that were successively collected. RESULTS: Daily microalbumin excretion varied from 2.4 to 168.7 mg/24 hr with a median value of 22.9 mg, and Uma/Ucr ranged from 3.4 to 200 g/mg with a median value of 29.0 g/mg. An excellent correlation was found between the microalbumin excretion measured from the 24-hour urine collections and the first-morning urine Uma/Ucr ratio (R=0.93, P<0.001). All patients that excreted more than 30 mg albumin in the 24-hour urine samples also had an Uma/Ucr of more than 30 g/mg. Patients who had less than 30 g/mg of Uma/Ucr were unlikely candidates for microalbuminuria. CONCLUSIONS: This study indicates that measurements of Uma/Ucr in first-morning urine samples are a simple and reliable alternative to measurements of the urinary albumin excretion rate in the 24-hour urine collections.
Creatinine* ; Diabetic Nephropathies ; Humans ; Urine Specimen Collection

BACKGROUND: Estimates of daily sodium (Na) and potassium (K) excretion were explicitly biased when using equations for adults. We aimed to develop equations to estimate them using overnight urine from Japanese children and adolescents. METHODS: The subjects comprised 70 students aged 10.49-15.76 years: validation group, n = 34; and verification group, n = 36. Each subject performed two operations of overnight spot urine (U RESULTS: In validation, we formulated Na excretion (mg d CONCLUSION We obtained validated equations to estimate daily Na and K excretion with accessible variables such as Na, K, and Cr concentrations of overnight urine, body height and weight, and age for children and adolescents. When using the obtained equations, caution should be paid to small but definite biases and measurement errors.
Adolescent ; Child ; Creatinine/urine* ; Female ; Humans ; Japan ; Male ; Potassium/urine* ; Sodium/urine*

In clinical practice, creatinine clearance (Ccr) remains the most commonly used laboratory assessment of glomerular function despite methodological and technical problems of urine collection. Schwartz et al. in 1976, reported that an accurate estimate of glomerular filtration rate (GFR) could be obtained from the simple determinations of plasma creatinine (Per) and body length (L): GFR (ml/min/1.73m2)=kL (cm)/Per (mg/100 ml), (k=constant). The subject of this study were 81 children admitted to our pediatric department from July, 1985 to June, 1987 and they were divided into three groups; group I, from 1 to 5 years old, group II, from 6 to 10 years old, group III, from 11 to 15 years old. The results were as following: 1) Measured creatinine clearance Ccr(M), ml/min/1.73m²) were 109.73±9.97 in group I, 108.26±9.02 in group II, 96.20±4.72 in group III and 105.48±5.23 in all age group. 2) Measured k(k(M)) obtained from CcrM=k Ht/Pcr were 0.49±0.03 in group I, 0.48±0.02 in group II, 0.43±0.02 in group III, and 0.47±0.02 in all age group (Ht; height). 3) Linear equations and correlation coefficient between Ht/Pcr (x) and Ccr (y) were y=0.82x-65.63 (r=0.99) in group I, y=0.61x-23.46(r=0.72) in group II, y=0.18x+54.44 (r=0.54) in group III and y=0.58x-22.13 (r=0.81) in all age group. 4) Ccr(E) was again estimated from linear equations between Ht/Pcr and Ccr(M) and k(E) was calculated with Ht/Pcr and Ccr(E) were 0.48±0.01 in group I, 0.49±0.01 in group II, 0.43±0.01 in group III and 0.47±0.00 in all age group. 5) Consistent values of k(E) and k(M) were highly significant as 95~97.5% in group I and II, 90~95% in group III and 97.5~99% in all age group. In summary, we could estimate GFR with height, plasma creatinine and measured k(k(M)) according to the age in easy and rapid way.
Child* ; Creatinine* ; Glomerular Filtration Rate* ; Humans ; Plasma* ; Urine Specimen Collection

AIMTo explore the characteristics of the urinary excretion in the elderly patients and to offer some advice for the prevention and treatment of hyponatremia in the elderly patients.

METHODS42 inpatients aged over 80 were divided into tow groups according to their creatinine clearance rate (CCR). Meanwhile, 24 patients aged 45-59 and 31 patients aged 60-79 were chosen as the control groups. All patients were examined 24h urinary electrolytes and CCR.

RESULTS(1) The CCR in the elderly group was lower than in the middle-aged and old group and the 24 h urinary sodium excretion was accordingly diminished than the two groups. 24 h urinary sodium excretion in CCR abnormal group was also diminished than in CCR normal group. The urinary sodium excretion was not linearly correlate with the CCR in middle-aged group and old group but was linearly correlate in the elderly group. (2) The elderly patients' capability of holding blood sodium and excreting potassium was declined in the CCR normal group. But the urinary excretion of sodium, potassium and phosphonium were all diminished in CCR abnormal group. (3) All patients' sodium intake was higher than the criteria made by China Hypertension Association.

CONCLUSIONTheir urinary sodium excretion is linearly correlate with CCR. Urinary sodium excretion is increased when the elderly patients' renal function is relative normal but when the renal function is severely damaged, urinary sodium excretion is diminished.

Age Factors ; Aged ; Aged, 80 and over ; Calcium ; urine ; Coronary Disease ; urine ; Creatinine ; metabolism ; Humans ; Male ; Middle Aged ; Potassium ; urine ; Sodium ; urine

OBJECTIVETo study the value of the determination of serum and urine haptoglobin (HP) and alpha 1-antitrypsin (AAT) in predicting the response to glucocorticoid therapy in children with primary nephrotic syndrome (PNS).

METHODSA total of 84 children with PNS were classified to steroid-sensitive nephrotic syndrome (SSNS) (n=58) and steroid-resistant nephrotic syndrome (SRNS) groups (n=26). Forty healthy children were randomly selected for the control group. HP and AAT levels in blood and urinary samples were determined using ELISA. The efficiency of HP and AAT in predicting the response to glucocorticoid treatment of PNS was evaluated by the receiver operating characteristic (ROC) curve.

RESULTSCompared with the control group, both the SSNS and SRNS groups had significantly higher serum HP concentrations and urine AAT/Cr ratio before treatment (P<0.05); compared with the SSNS group, the SRNS group had significantly higher serum HP concentrations and urine AAT/Cr ratio before treatment and after one week and four weeks of treatment (P<0.05). Serum HP had the highest efficiency in predicting the response to glucocorticoid treatment of PNS at the concentration of 37.935 mg/mL, with the sensitivity and specificity being 92.3% and 86.2% respectively. Urine AAT/Cr ratio had the highest prediction efficiency at 0.0696, with the sensitivity and specificity being 100% and 79.3% respectively. ROC curve analysis of serum HP combined with urine AAT/Cr ratio showed a better prediction efficiency, with the sensitivity and specificity being 92.3% and 96.6% respectively.

CONCLUSIONSThe increase in serum HP level or urine AAT/Cr ratio may indicate glucocorticoid resistance in the early stage of PNS. A combination of the two can achieve better efficiency in the prediction of SRNS.

Child ; Child, Preschool ; Creatinine ; urine ; Female ; Glucocorticoids ; therapeutic use ; Haptoglobins ; analysis ; urine ; Humans ; Male ; Nephrotic Syndrome ; blood ; drug therapy ; urine ; alpha 1-Antitrypsin ; analysis ; blood ; urine

Acute kidney injury (AKI) and chronic kidney disease (CKD) are major health problems. Urinary biomarkers have both diagnostic and prognostic utility in AKI and CKD. However, how biomarker excretion rates should be reported, especially whether they should be normalised to urinary creatinine concentration (uCr), is controversial. Some studies suggest that normalisation to uCr may be inappropriate at times, as urinary creatinine excretion rate may vary greatly, depending on the situation. Notably, recent studies suggest that while normalisation of values to UCr may be valid for the evaluation of CKD and prediction of AKI sequelae and occurrences, it could be inappropriate for the diagnosis of AKI, or in the presence of certain acute kidney disease states.
Acute Kidney Injury ; urine ; Biomarkers ; urine ; Creatinine ; urine ; Glomerular Filtration Rate ; Humans ; Kidney ; physiopathology ; Nephrology ; methods ; standards ; Renal Insufficiency, Chronic ; urine ; Treatment Outcome ; Urinalysis ; standards

OBJECTIVETo examine the urinary level of tissue factor (uTF) and its procoagulant activity (PCA) in patients with diabetes mellitus, and explore the relationship between uTF and renal damage in diabetes mellitus.

METHODSEighty-six patients with type 2 diabetes mellitus were divided into 3 groups according to urine albumin excretion (UACR), namely normal albuminuria group, microalbuminuria group and macroalbuminuria group. The levels of uTF, PCA, blood urea nitrogen (BUN), serum creatinine (CRE), serum cystatin C (CYSC), glycohemoglobin A1c (HbA1c), and high-sensitivity C-reactive protein (hs-CRP) were measured in all the patients and 21 healthy controls.

RESULTSCompared with normal control, the diabetic patients showed significantly increased levels of uTF and PCA. The urinary TF-PCA was positively correlated to BUN, CYSC, CRE, UACR, fasting glucose and hs-CRP, but not to uTF; only hs-CRP, UACR were positively correlated to uTF.

CONCLUSIONuTF is probably implicated in the development and progression of diabetic nephropathy.

Adult ; Albuminuria ; urine ; Blood Coagulation ; Case-Control Studies ; Creatinine ; urine ; Diabetes Mellitus, Type 2 ; physiopathology ; urine ; Female ; Humans ; Male ; Middle Aged ; Thromboplastin ; urine

BACKGROUND: Low-dose exposure to organophosphate (OP) insecticides during pregnancy may adversely affect neurodevelopment in children. To evaluate the OP exposure levels, single urine sampling is commonly adopted to measure the levels of dialkylphosphates (DAPs), common OP metabolites. However, the inter-day variations of urinary DAP concentrations within subjects are supposed to be large due to the short biological half-lives of the metabolites, and it is thus considered difficult to accurately assess OP exposure during pregnancy with single sampling. This study aimed to assess intra-individual variations of DAP concentrations and the reproducibility of the exposure dose categorization of OPs according to DAP concentration ranges in pregnant women in Japan. METHODS: Urine samples were collected from 62 non-smoking pregnant women (12-22 weeks of gestation) living in Aichi Prefecture, Japan. First morning void (FMV) and spot urine samples taken between lunch and dinner on the same day were collected on five different days during 2 weeks. The concentrations of DAP and creatinine in urine samples were measured using an ultra performance liquid chromatography with tandem mass spectrometry. Creatinine-adjusted and unadjusted concentrations were used for the intraclass correlation coefficient (ICC) calculations and surrogate category analyses. RESULTS: For all DAP metabolites, the creatinine-adjusted single ICCs exceeded 0.4, indicating moderate reliability. Overall, ICCs of spot urine samples taken in the afternoon were better than those taken as FMV. Surrogate category analyses showed that participants were categorized accurately into four exposure dose groups according to the quartile points. CONCLUSION This study indicated that a single urine sample taken in the afternoon may be useful in assessing OP exposure as long as the exposure is categorized into quartiles when conducting epidemiological studies in early to mid-pregnant women in Japan.
Adult ; Chromatography, Liquid ; Creatinine ; urine ; Environmental Exposure ; analysis ; Environmental Monitoring ; methods ; Environmental Pollutants ; urine ; Female ; Humans ; Japan ; Mass Spectrometry ; Organophosphates ; urine ; Pesticides ; urine ; Pregnancy ; Pregnant Women ; Young Adult

OBJECTIVETo investigate the urinary neutrophil gelatinase-associated lipocalin (NGAL) concentration in children with idiopathic nephrotic syndrome (INS) and its clinical significance.

METHODSThirty-four children newly diagnosed with INS received oral prednisone for 4 weeks. Patients whose urinary protein did not become negative were classified as steroid-resistant nephrotic syndrome (SRNS) group, while those whose urinary protein did become negative were classified as steroid-sensitive nephrotic syndrome (SSNS) group. Morning midstream urine specimens were collected from all patients before use of prednisone and after 1, 2, 3, and 4 weeks of treatment with prednisone. Enzyme-linked immunosorbent assay was used to measure the urinary NGAL concentration. Meanwhile, urinary creatinine (Cr) concentration was measured, and urinary NGAL concentration in a single urine collection was adjusted according to the urinary Cr excretion. The two groups were compared in terms of urinary NGAL/Cr ratio.

RESULTSCompared with the SRNS group, the SSNS group had significantly decreased urinary NGAL/Cr ratios after 3 and 4 weeks of prednisone treatment (P < 0.05). Compared with the SRNS group, the SSNS group had a significantly decreased urinary β2-MG/Cr ratio after 4 weeks of prednisone treatment (P < 0.05). In both groups, urinary NGAL/Cr ratio was positively correlated with urinary protein/Cr ratio (r = 0.510, P < 0.01). The results of ROC curve analysis showed when diagnostic cut-off point of urinary NGAL/Cr was 0.043 by 3 weeks after treatment, sensitivity and specificity achieved 100% and 79.2% respectively.

CONCLUSIONSUrinary NGAL/Cr ratio remains high in children with SRNS, while this ratio decreases gradually during prednisone treatment in children with SSNS, and it falls ahead of urinary β2-MG/Cr ratio. These results suggest that dynamic monitoring of urinary NGAL/Cr ratio is useful for early judgment of response to prednisone in patients with INS.

Acute-Phase Proteins ; urine ; Child ; Child, Preschool ; Creatinine ; urine ; Female ; Humans ; Lipocalin-2 ; Lipocalins ; urine ; Male ; Nephrotic Syndrome ; drug therapy ; urine ; Prednisone ; therapeutic use ; Proto-Oncogene Proteins ; urine ; beta 2-Microglobulin ; urine