Urinary growth hormone (GH) excretion was quantitated in 12-hr overnight urine collections obtained from 13 children with complete growth hormone deficiency (CGHD). 6 children with partial growth hormone deficiency (PGHD), 5 children with short stature and normal GH provocation tests (NSC), and 5 normal control children (NC) to investigate whether the measurement of urinary GH can clearly separate the PGHD and CGHD groups from the NSC and NC groups. In addition, the urinary excretion of GH was measured in CGHD after sc injections of 0.1 IU/kg GH three times a week and daily in an attempt to determine the optimal replacement dose. The results were as follows. 1) The 12-hr urinary GH excretion cleary separated the CGHD (1.2+/-1.1 ng/12 hr; range, 0.3-3.1, n=13) and PGHD (3.7+/-2.4 ng/12 hr; range, 0.9-6.8 n=6) groups from the NSC (14.0+/-3.6 ng/12 hr; range, 8.5-18.2 n=5) and NC (12.7+/-5.8 ng/12 hr; range, 6.9-20.8, n=5) groups without any overlap. 2) There were significant difference in 12-hr urinary GH excretion between CGHD and PGHD, but the higher values in CGHD groups overlapped some of the lower values in PGHD group. 3) There were no differencies in 12-hr urinary GH excretion between NC and NSC. 4) A 12-hr urinary GH values less than 6.9 ng/12 hr suggested GH deficiency. 5) The CGHD patients who received o.1 IU/kg GH. sc. daily GH levels within the range of the mean +/-SD in NC. but those who received theree times a week had daily variable urinary GH levels. These results suggest that the measurement of 12-hr nocturnal urinary GH excretion monitering of GH therapy response.
Child ; Growth Hormone* ; Humans ; 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

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

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

BACKGROUND: The purpose of this study was to determine whether cleansing the perineum and urethral meatus and using midstream urine affect the rate of bacterial contamination of urine specimens, and to determine the optimum urine collection method. We studied 41 asymptomatic healthy nursing school students. Women who were menstruating were not excluded from this study. METHOD: The first and midstream urinesamples were collected during consecutive urinationsby each woman. The first sample was not a clean-catch specimen, and the second one was a clean-catch specimen. Both specimens were studied by urinalysis and bacterial culture with standard methods. RESULTS: 41 women met the study criteria and 39 successfully completed the study. None of the urine cultures were positive. 68.3% of the non clean-catch first urine cultures, 53.7% of the non clean-catch midstream cultures, 33.3% of the first clean-catch urine culteres and 30.8% of the midstream clean-catch urine were found to be contaminated. There was a significant difference in the bacterial contamination rates between the first and midstream urine, and the clean-catch and non clean-catch urine(p=0.035, p=0.001 respectively). On urinalysis, 7.3% of the non clean-catch first urine, 7.3% of the non clean-catch midstream urine, 2.6% of the clean-catch first urine and 2.6% of clean-catch midstream urine were found to be above grade 2. CONCLUSIONS: According to our results, the bacterial contamination rate was the lowest in midstream and clean catch urine specimens. Threrfore it is recommended that the midstream clean-catch technique is the standard practice for collecting urine specimens for bacterial culture in women.
Female ; Humans ; Perineum ; Schools, Nursing ; Urinalysis ; Urine Specimen Collection*

BACKGROUND: Refrigeration is the most common method of preservation for 24 hour urine collection. We tried to find out if the concentrations of the frequently measured chemicals in urine refrigerated for 24 hours were different from those in fresh urine. METHODS: The concentration of calcium, phosphorus, uric acid, creatinine, sodium, potassium, chloride, and protein was measured in fresh urine specimens for routine urine analysis. After refrigeration of the rest of the urine specimens for 24 hours, the same tests were performed, and the results of them were compared with those of fresh urine. Some urine specimens showed precipitation and decreased uric acid concentration after precipitation, and the chemical properties of them were determined statistically. RESULTS: The concentrations of the protein, phosphorus, creatinine, sodium, potassium, and chloride of refrigerated urine was not different statistically from those of the fresh one, but calcium and uric acid showed statistical difference between fresh and refrigerated samples (P<0.05). Urine specimens with precipitation and decreased uric acid showed chemical characteristics of high uric acid concentration and low pH. CONCLUSIONS: For the measurements of total protein, phosphorus, creatinine, sodium, potassium, and chloride, the urine can be refrigerated while collection of 24 hours, but additional procedure is recommended for the measurement of calcium and uric acid.
Calcium ; Creatinine ; Hydrogen-Ion Concentration ; Phosphorus ; Potassium ; Refrigeration ; Sodium ; Uric Acid ; Urine Specimen Collection

Hypomagnesemia may arise from various disorders such as renal magnesium wasting, familial hypomagnesemia, inadequate intake and increased gastrointestinal loss. Hypomagnesemia and hypocalcemia were found in a month-old female patient with generalized tonic-clonic seizure. Twenty-four hour urine collection samples were used to assess renal magnesium wasting; fractional excretion of 24-hr urine magnesium was less than 1.45%, i.e., within the normal limits. The patient had no history of chronic diarrhea or failure to thrive, which supports the conclusion that intake was adequate. She had no family history of hypocalcemia, hypomagnesemia, or seizures. Here, we report a case of idiopathic hypomagnesemia.
Diarrhea ; Failure to Thrive ; Female ; Humans ; Hypocalcemia ; Magnesium ; Seizures ; Urine Specimen Collection

OBJECTIVES: The purpose of this study was to evaluate the clinical usefulness of the protein/creatinine ratio of a spot urine specimen for early detection of proteinuria in the pregnancy induced hypertension and to suggest optimum cut-off value of that. STUDY DESIGN: A spot urine specimen and 24 hour urine collection for the proteinuria were ordered for 36 women admitted to obstetric unit for pregnancy induced hypertension and ROC curve analysis was performed to evaluate the usefulness of the protein/creatinine ratio of a spot urine specimen and to suggest optimum cut-off value. RESULT: The protein/creatinine ratio of spot urine positively correlated well with 24 hour urine proteinuria. (r=0.4322, p=0.0085) and the optimum cut-off value of the protein/creatinine ratio of a spot urine specimen to maximize the diagnostic accuracy was 5.0(Youden's index=0.66). CONCLUSION: We conclude that the protein / creatinine raio of a spot urine specimen may be a simple and inexpensive method for evaluation of proteinuria in the pregnancy induced hypertension when frequent determinations are necessary. This should improve clinical care, especially when managing hypertensive pregnant women as outpatients.
Creatinine* ; Female ; Humans ; Hypertension, Pregnancy-Induced* ; Pregnancy ; Pregnancy* ; Pregnant Women ; Proteinuria ; ROC Curve ; Urine Specimen Collection

OBJECTIVE: To assess the diagnostic accuracy of random urine protein-creatinine (P/C) ratio for prediction of significant proteinuria in preeclampsia as an alternative to the time-consuming 24-hour urine protein collection. METHODS: Retrospective record analysis was performed on 140 pregnant women who were admitted with suspicion for preeclampsia from January 2006 to June 2011. Random urine protein and/or 24-hour urine protein levels were assessed and their correlation to random urine P/C ratio and 24-hour urine protein excretion was evaluated. RESULTS: Out of 140 patients, random urine P/C ratio or/and 24-hour urine protein was performed in 79 patients to evaluate significant proteinuria. Of 79 patients, 46 (58%) underwent both tests whereas in 33 women (42%) 24-hour urine collection was not available due to urgent delivery. In 39 cases (85%), significant proteinuria (> or =300 mg/24 hr) was detected with 6 cases (13%) having values over 5,000 mg/24 hr, corresponding to the diagnosis of severe preeclampsia. Random urine P/C ratio highly correlated with 24-hour urine protein excretion (r=0.823, P<0.01). The optimal random urine P/C ratio cutoff points were 0.63 and 4.68 for 300 mg/24 hr and 5,000 mg/24 hr of protein excretion, respectively. with each sensitivity, specificity, and positive and negative predictive values of 87.1%, 100%, 100%, and 58.3%; and 100%, 85%, 50%, and 100%, for significant and severe preeclampsia, respectively. CONCLUSION: Random urine P/C ratio is a reliable indicator of significant proteinuria in preeclampsia and may be better at providing earlier diagnostic information than the 24-hour urine protein excretion with more accuracy than the urinary dipstick test.
Female ; Humans ; Pre-Eclampsia ; Pregnant Women ; Proteinuria ; Retrospective Studies ; Sensitivity and Specificity ; Urine Specimen Collection

BACKGROUND/OBJECTIVES: The aims of the present study are: 1) to quantify sodium consumption of patients with unstable or uncontrolled hypertension, 2) to investigate if reduced sodium intake can lower BP in these patients, and 3), to assess the acceptability and feasibility of this approach. SUBJECTS/METHODS: This study included 25 adults (age: 50+ years) with frequently elevated BP or patients with uncontrolled, uncomplicated hypertension despite drug treatment in a general practice setting. BP and salt intake (24h urinary excretion and food records) were measured at baseline and after a sodium reduced diet. RESULTS: Mean (+/- SD) systolic (SBP) over diastolic (DBP) blood pressure (mmHg) at baseline was 150.7 (+/- 9.5)/84.149 (+/- 5.6). Mean urinary sodium excretion was 146 mmol/24h. A reduction of 28 mmol sodium excretion decreased SBP/DBP to 135.5 (+/- 13.0)/82.5 (+/- 12.8) (P < 0.001). After one month of no dietary advice, only in 48%, SBP was still < or =140 mmHg. CONCLUSION: Assessment of sodium intake using food records, 24h urine collections and probing questions to identify use of sodium containing supplements or drugs are essential for tailored advice targeted at sodium intake reduction. The results of the present study indicate that reduced sodium intake can lower BP after 4 weeks in unstable or uncontrolled hypertensive patients.
Adult ; Blood Pressure* ; Diet ; General Practice ; Humans ; Hypertension ; Primary Health Care* ; Sodium* ; Urine Specimen Collection