An Aggregate Urine Analysis Tool to Detect Acute Dehydration

Hahn, Robert G.; Waldréus, Nana

doi:10.1123/ijsnem.23.4.303

Cited by 46 publications

(97 citation statements)

References 14 publications

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“…The urine analysis used here indicates fluid retention due to any cause, but a deficit of extracellular fluid is most likely to be involved, as we excluded patients with cardiac and renal failure. Confounding effects of excessive salt intake or an extremely small or large muscle mass can be estimated by a gross discrepancy in the two urinary biomarkers [14], but this was not observed in the present study.…”

Section: Discussioncontrasting

confidence: 50%

“…The urinary creatinine concentration and the urinary osmolality show a 10-fold variation in healthy humans [14], and this can be attributed to how the kidneys are set to excrete or conserve water. The urine analysis used here indicates fluid retention due to any cause, but a deficit of extracellular fluid is most likely to be involved, as we excluded patients with cardiac and renal failure.…”

Section: Discussionmentioning

confidence: 99%

“…Creatinine and osmotically active particles are excreted at a fairly constant rate. Therefore, reduced excretion of water can be indicated by a raised urinary creatinine concentration and urinary osmolality [12][13][14]. Pre-infusion fluid retention was diagnosed when the creatinine concentration in the urine collected before the infusions started was > 7.0 mmol.l À1 and/or the osmolality was > 700 mOsmol.kg À1 .…”

Section: Methodsmentioning

confidence: 99%

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Isotonic saline in elderly men: an open‐labelled controlled infusion study of electrolyte balance, urine flow and kidney function

et al. 2015

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SummaryIsotonic saline is a widely-used infusion fluid, although the associated chloride load may cause metabolic acidosis and impair kidney function in young, healthy volunteers. We wished to examine whether these effects also occurred in the elderly, and conducted a crossover study in 13 men with a mean age of 73 years (range 66-84), who each received intravenous infusions of 1.5 l of Ringer's acetate and of isotonic saline. Isotonic saline induced mild changes in plasma sodium (mean +1.5 mmol.l À1 ), plasma chloride (+3 mmol.l À1 ) and standard bicarbonate (À2 mmol.l À1 ). Three hours after starting the infusions, 68% of the Ringer's acetate and 30% of the infused saline had been excreted (p < 0.01). The glomerular filtration rate increased in response to both fluids, but more after the Ringer's acetate (p < 0.03). Pre-infusion fluid retention, as evidenced by high urinary osmolality (> 700 mOsmol.kg À1 ) and/or creatinine (> 7 mmol.l À1 ), was a strong factor governing the responses to both fluid loads.

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Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Isotonic saline in elderly men: an open‐labelled controlled infusion study of electrolyte balance, urine flow and kidney function

et al. 2015

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“…Urine colour was assessed immediately by holding a 10 ml tube of urine next to a colour scale [6] (available at www.hydrationcheck.com). The colours used have been assigned RGB codes [7]. One urine tube was used to measure albumin excretion (a sign of glomerular damage), as well as the concentration of metabolic waste products (which can be used to quantify the degree of dehydration-induced renal water conservation) [7,8].…”

Section: Methodsmentioning

confidence: 99%

Renal injury during hip fracture surgery: an exploratory study

Hahn

2015

Anaesthesiol Intensive Ther

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Background: The present observational study was undertaken to identify potential markers of poor outcome, such as renal failure and mortality, after hip fracture surgery. Methods: Forty-three patients, with a mean age of 78 years, were studied having undergone acute hip fracture surgery. Analysis included the urinary excretion of cortisol, albumin and sodium. The degree of fluid retention was evaluated based on the urinary excretion of metabolic end products. Fluid retention and the excretion of albumin and neutrophil gelatinase-associated lipocalin (NGAL) were measured repeatedly in a sub-group of 15 patients who also underwent haemodynamic monitoring. The perioperative change in serum creatinine and a 30-day mortality served as outcome measures. Results: Although serum creatinine increased by > 25% in 21% of the patients, only a high preoperative creatinine concentration correlated with a 30-day mortality. The subgroup analysis revealed that fluid retention was pronounced and remained essentially unchanged up to the first postoperative day. A rise in serum creatinine was always preceded by increased urinary excretion of NGAL that, in turn, was associated with preoperative fluid retention. The only perioperative event that correlated with a higher 30-day mortality was perioperative aggravation of albuminuria (67% vs 0%, P < 0.01), which became more common with advanced age and a low cardiac index. Conclusions: Two different mechanisms seem to affect the kidneys during hip fracture surgery. The first elevates the serum creatinine concentration while the second increases the albuminuria. Only the second mechanism had a bearing on mortality.

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“…The magnitude of reduction in blood volume can be considerable amounting to approximately 10% of the pre-stress volume (9). This reduction exceeds the apparent decrease in blood volume that could arise from random fluctuations and measurements errors in the Hematocrit ratio and Hemoglobin concentration (13). When a change in blood volume, accompanies thermal stress or exercise, a transient shift of fluid into and out of intravascular space occurs.…”

Section: Discussionmentioning

confidence: 99%

Profiling of Body Hydration and Related Blood Parameters under Hot-Arid Conditions among Indian Population doing Graded Physical Activity

Bharadwaj¹,

Baburaj²,

Bajaj³

et al. 2017

IJCRR

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This study highlights the effect of extreme heat stress exposure (WBGT Index 36.24°C) on hematological variables while performing graded physical activity (sedentary, moderate and heavy). Total 30 participants were involved in the study and were randomly distributed into batches of 10 under three categories of physical activity. Volunteers performed physically strenuous work while being exposed to ambient heat stress (hot -arid conditions). White Blood Corpuscles (WBC) count in heavy work group [506 kcal/ hr energy expenditure] showed significant increase from pre to post exposure (p < 0.01). No other group showed significant change in WBC count. Haematocrit % (Hct %) was significantly increased among heavy work group (p < 0.01) whereas Red Blood Corpuscles (RBC) count and Red Blood Cell Distribution Width (RDW) showed no significant increase. Blood viscosity showed increase among moderate work group [412kcal / hr energy expenditure] (p<0.05) and heavy work group (p< 0.001). These alterations indicate that participants exposed to high ambient temperature while doing graded physical activity underwent considerable hypo-hydration (sweat loss upto 4% of body weight) which got reflected in hematological parameters. This depletion of body fluid got reflected on blood viscosity and WBC count at a stage when the condition was not subjectively perceived. Data may be beneficial to identify such hypo hydration status before the condition is manifested visibly or symptomatically.

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An Aggregate Urine Analysis Tool to Detect Acute Dehydration

Abstract: Urine sampling can be used to estimate weight loss due to dehydration in adults up to age 70. A robust dehydration index based on four indicators reduces the influence of confounders.

Cited by 46 publications

References 14 publications

Isotonic saline in elderly men: an open‐labelled controlled infusion study of electrolyte balance, urine flow and kidney function

Isotonic saline in elderly men: an open‐labelled controlled infusion study of electrolyte balance, urine flow and kidney function

Renal injury during hip fracture surgery: an exploratory study

Profiling of Body Hydration and Related Blood Parameters under Hot-Arid Conditions among Indian Population doing Graded Physical Activity

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