Estimating 24-Hour Urine Sodium From Multiple Spot Urine Samples

Overview

Journal J Clin Hypertens (Greenwich)

Specialty Cardiology & Vascular Diseases

Date 2016 Oct 14

PMID 27735123

Citations 8

Authors

Moo-Yong Rhee

Ji-Hyun Kim

Sung-Joon Shin

Namyi Gu

Deuk-Young Nah

Ju-Hyun Park

Sun-Woong Kim

Hyun Ja Kim

Kyung Won Oh

Ji-Hyeon Kim

Sim-Yeol Lee

Affiliations

Soon will be listed here.

Abstract

The authors developed an equation to estimate 24-hour urine sodium (24HUNa) using the average of three spot urine (SU) samples (morning-first, morning, and evening) from 74 individuals and validated this equation using the average of three SU samples (morning-first, daytime, and evening) from 174 additional individuals. Compared with previously published equations using a single SU sample, the currently developed equation using the average of three SU samples showed much lower bias from measured 24HUNa (-2.9 vs >10 mmol/24 h). The intraclass and concordance correlation coefficients of the proposed equation using the average of three SU samples were 0.909 and 0.832, respectively. The limits of agreement were -64.1-58.3 mmol/24 h and approximately 100 mmol/24 h for the currently developed and previously published equations, respectively. All equations showed a tendency to overestimate or underestimate 24HUNa in a manner dependent on the level of 24HUNa but irrespective of the number of SU samples considered. Nonetheless, among the currently tested equations, our equation using the average of three SU samples provided the best estimation of 24HUNa at a population level.

Citing Articles

Evaluation of three prediction formulas of 24-hour urinary sodium excretion in Chinese residents: a systematic review and meta-analysis.

Qi Z, Tang S, Wu B, Li Y, Yang H, Wang K Public Health Nutr. 2024; 27(1):e71.

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Development and application of the sodium index to estimate and assess sodium intake for Korean adults.

Lee Y, Hyun T, Ro H, Heo Y, Choi M Nutr Res Pract. 2022; 16(3):366-378.

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Sodium to creatinine ratio in spot urine is associated with heart failure hospitalization in Japanese high-risk patients.

Sadanaga T, Hirota S Exp Ther Med. 2022; 23(6):379.

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Sodium Intake, Blood Pressure and Cardiovascular Disease.

Rhee M, Jeong Y Korean Circ J. 2020; 50(7):555-571.

PMID: 32281323 PMC: 7321755. DOI: 10.4070/kcj.2020.0042.

Estimating mean population salt intake in Fiji and Samoa using spot urine samples.

Santos J, Rosewarne E, Hogendorf M, Trieu K, Pillay A, Ieremia M Nutr J. 2019; 18(1):55.

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References

Knuiman J, Hautvast J, Van der Heyden L, Geboers J, JOOSSENS J, Tornqvist H . A multi-centre study on completeness of urine collection in 11 European centres. I. Some problems with the use of creatinine and 4-aminobenzoic acid as markers of the completeness of collection. Hum Nutr Clin Nutr. 1986; 40(3):229-37. View

Ji C, Miller M, Venezia A, Strazzullo P, Cappuccio F . Comparisons of spot vs 24-h urine samples for estimating population salt intake: validation study in two independent samples of adults in Britain and Italy. Nutr Metab Cardiovasc Dis. 2013; 24(2):140-7. DOI: 10.1016/j.numecd.2013.06.011. View

Critchley L, Critchley J . A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J Clin Monit Comput. 2003; 15(2):85-91. DOI: 10.1023/a:1009982611386. View

Kawasaki T, Itoh K, Uezono K, Sasaki H . A simple method for estimating 24 h urinary sodium and potassium excretion from second morning voiding urine specimen in adults. Clin Exp Pharmacol Physiol. 1993; 20(1):7-14. DOI: 10.1111/j.1440-1681.1993.tb01496.x. View

Rhee M, Kim J, Shin S, Gu N, Nah D, Park J . Estimating 24-Hour Urine Sodium From Multiple Spot Urine Samples. J Clin Hypertens (Greenwich). 2016; 19(4):431-438. PMC: 8030767. DOI: 10.1111/jch.12922. View

Strazzullo P, DElia L, Kandala N, Cappuccio F . Salt intake, stroke, and cardiovascular disease: meta-analysis of prospective studies. BMJ. 2009; 339:b4567. PMC: 2782060. DOI: 10.1136/bmj.b4567. View

Uechi K, Asakura K, Ri Y, Masayasu S, Sasaki S . Advantage of multiple spot urine collections for estimating daily sodium excretion: comparison with two 24-h urine collections as reference. J Hypertens. 2015; 34(2):204-14. DOI: 10.1097/HJH.0000000000000778. View

WESSON Jr L . ELECTROLYTE EXCRETION IN RELATION TO DIURNAL CYCLES OF RENAL FUNCTION. Medicine (Baltimore). 1964; 43:547-92. DOI: 10.1097/00005792-196409000-00002. View

Mente A, ODonnell M, Dagenais G, Wielgosz A, Lear S, McQueen M . Validation and comparison of three formulae to estimate sodium and potassium excretion from a single morning fasting urine compared to 24-h measures in 11 countries. J Hypertens. 2014; 32(5):1005-14. DOI: 10.1097/HJH.0000000000000122. View

10.

Rhee M, Kim J, Shin S, Gu N, Nah D, Hong K . Estimation of 24-hour urinary sodium excretion using spot urine samples. Nutrients. 2014; 6(6):2360-75. PMC: 4073156. DOI: 10.3390/nu6062360. View

11.

Brown I, Dyer A, Chan Q, Cogswell M, Ueshima H, Stamler J . Estimating 24-hour urinary sodium excretion from casual urinary sodium concentrations in Western populations: the INTERSALT study. Am J Epidemiol. 2013; 177(11):1180-92. PMC: 3664342. DOI: 10.1093/aje/kwt066. View

12.

Tanaka T, Okamura T, Miura K, Kadowaki T, Ueshima H, Nakagawa H . A simple method to estimate populational 24-h urinary sodium and potassium excretion using a casual urine specimen. J Hum Hypertens. 2002; 16(2):97-103. DOI: 10.1038/sj.jhh.1001307. View

13.

Hutcheon J, Chiolero A, Hanley J . Random measurement error and regression dilution bias. BMJ. 2010; 340:c2289. DOI: 10.1136/bmj.c2289. View

14.

Park S, Park J, Lakatta E . Association of central hemodynamics with estimated 24-h urinary sodium in patients with hypertension. J Hypertens. 2011; 29(8):1502-7. PMC: 4535170. DOI: 10.1097/HJH.0b013e3283486311. View

15.

Rhee M . High sodium intake: review of recent issues on its association with cardiovascular events and measurement methods. Korean Circ J. 2015; 45(3):175-83. PMC: 4446810. DOI: 10.4070/kcj.2015.45.3.175. View

16.

Rhee M, Shin S, Park S, Kim S . Sodium intake of a city population in Korea estimated by 24-h urine collection method. Eur J Clin Nutr. 2013; 67(8):875-80. DOI: 10.1038/ejcn.2013.87. View

17.

Yamori Y, Kihara M, Fujikawa J, Soh Y, Nara Y, Ohtaka M . Dietary risk factors of stroke and hypertension in Japan -- Part 1: Methodological assessment of urinalysis for dietary salt and protein intakes. Jpn Circ J. 1982; 46(9):933-8. DOI: 10.1253/jcj.46.933. View

18.

ODonnell M, Mente A, Rangarajan S, McQueen M, Wang X, Liu L . Urinary sodium and potassium excretion, mortality, and cardiovascular events. N Engl J Med. 2014; 371(7):612-23. DOI: 10.1056/NEJMoa1311889. View

19.

He F, MacGregor G . Reducing population salt intake worldwide: from evidence to implementation. Prog Cardiovasc Dis. 2010; 52(5):363-82. DOI: 10.1016/j.pcad.2009.12.006. View

20.

Bonett D . Sample size requirements for estimating intraclass correlations with desired precision. Stat Med. 2002; 21(9):1331-5. DOI: 10.1002/sim.1108. View