Average urinary excretion of sodium in 24 hours can be estimated from a spot-urine specimen.

Kawasaki, Terukazu; Ueno, Makoto; Uezono, Keiko; Kawazoe, Nobuyuki; Nakamuta, Sumiko; Ueda, Kazuo; Omae, Teruo

doi:10.1253/jcj.46.948

Cited by 45 publications

(39 citation statements)

References 16 publications

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“…This may also help to explain why the SMU method is not widely used to estimate the salt intake of hypertensive patients at present. Owing to a difference of approximately 1 g daily between the salt intake obtained in the sitting position versus the sitting and standing position, and because of daily salt intake that varies in normal life, 29 it is not practical to advise outpatients undergoing this test to spend their time equally in the sitting position and standing position; however, it is useful to advise them not to lie down. In the Japanese guideline, a spot urine method developed by Tanaka et al 30 is recommended for the general estimation of daily salt intake because urine collection can be done at any time to measure the sodium:creatinine ratio.…”

Section: Discussionmentioning

confidence: 99%

The influence of posture on the estimation of daily salt intake by the second morning urine method

et al. 2010

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The second morning urine (SMU) method was developed to evaluate daily salt intake, but the posture that should be adopted until the SMU collection remains unclear. This study investigated the influence of posture in hypertensive patients who underwent this test. The subjects were 100 patients who could collect 24-h urine samples correctly and were on a diet containing 7 g of salt per day. Their daily salt intake was estimated for three consecutive days in the recumbent, sitting, and sitting and standing positions (one posture each day). Estimated salt intake in the recumbent position (10.9±2.4 g day À1 ) was higher than in the sitting position (7.5 ± 2.0 g day À1 ) and the sitting and standing position (6.3 ± 1.7 g day À1 ). The salt intake estimated in the sitting and standing position was similar to that obtained by 24-h urine collection (6.3 ± 1.6 g day À1 ) and was significantly (r¼0.44, Po0.05) correlated with the 24-h urine value. The actual difference in estimated salt intake between the two methods was 0.0 ± 1.7 g day À1 . There were no significant differences in estimated salt intake between the two methods in patients taking different classes of antihypertensive drugs. In conclusion, adopting the sitting and standing position until the SMU collection is important for the correct estimation of daily salt intake, and this method could replace the 24-h collection method because of its convenience, especially in outpatients.

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Section: Discussionmentioning

confidence: 99%

The influence of posture on the estimation of daily salt intake by the second morning urine method

et al. 2010

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“…Urine samples were obtained (1) in the early morning just before the administration of any medication including TLV and other diuretics on day 1, (2) at 4 hours after the administration of TLV on day 1, and (3) in the early morning just before the administration of any medication including TLV on day 7. Estimated amount of urinary sodium excretion during 24 hours (UNaEx 24 ) was calculated by the following formula, ie [U-NaEx 24 (mg/day)] = 2.3 × [urinary sodium concentration (U-Na) ( 13) Patients in whom UV on day 1 accomplished an increase compared with that of day 0 were defi ned as "responders" to TLV and the reverse as "non-responders", as we previously demonstrated its validity and reliability in association with various clinical parameters including amelioration of congestion. 14,15) Hyponatremia was defined as S-Na < 132 mEq/L considering the results of the receiver operating characteristics (ROC) analysis discussed below, and hypernatremia was defi ned as S-Na > 145 mEq/L.…”

Section: Methodsmentioning

confidence: 99%

Urine Sodium Excretion After Tolvaptan Administration Is Dependent Upon Baseline Serum Sodium Levels

et al. 2014

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SummarySeveral studies have demonstrated that tolvaptan (TLV) can improve hyponatremia in advanced heart failure (HF) patients with rare chance of hypernatremia. However, changes in serum sodium concentrations (S-Na) in patients with or without hyponatremia during TLV treatment have not been analyzed.Ninety-seven in-hospital patients with decompensated HF who had received TLV at 3.75-15 mg/day for 1 week were enrolled. Among 68 "responders", who had achieved any increases in urine volume (UV) during the fi rst day, urinary sodium excretion during 24 hours (U-NaEx 24 ) increased signifi cantly during one week of TLV treatment along with higher baseline S-Na (P < 0.05 and r = 0.325). Considering a cut-off value (S-Na, 132 mEq/L; AUC, 0.711) for any increases in U-NaEx 24 , we defi ned "hyponatremia" as S-Na < 132 mEq/L. In hyponatremic responders (n = 25), S-Na increased signifi cantly, although 1 week was not suffi cient for normalization (125.8 ± 5.0 versus 128.9 ± 4.3 mEq/L, P < 0.05), along with unchanged U-NaEx 24 (2767 ± 2703 versus 2972 ± 2950 mg/day, NS). In contrast, in normonatremic responders (n = 43), S-Na remained unchanged (136.6 ± 3.1 versus 137.4 ± 2.9 mEq/L, NS) along with increased UNaEx 24 (2201 ± 1644 versus 4198 ± 3550 mg/day, P < 0.05).TLV increased S-Na only in hyponatremic responders by way of pure aquaresis, but increased U-NaEx 24 only in normonatremic responders, which explains the scarcity of hypernatremia. Epithelial Na-channels in the distal nephrons, whose repression by TLV increases urinary sodium excretion, may be attenuated by reduced ATP-supply in worse hemodynamics under hyponatremia. (Int Heart J 2014; 55: 131-137) Key words: Heart failure, Vasopressin, Urine osmolality T he orally active vasopressin antagonists vaptans provide potential effects to treat chronic water-retaining disorders. 1) Among them, the vasopressin type 2 (V2) receptor antagonist tolvaptan (TLV) has been available for patients with heart failure (HF) with symptomatic congestion or hyponatremia.2) TLV has been demonstrated to ameliorate congestion, stabilize hemodynamics, and improve renal function without any signifi cant adverse effects.3-7) We also reported the effi cacy and safety of TLV in (1) amelioration of congestion even in stage D HF patients and (2) improvement of renal function by converting ongoing diuretics to TLV. 8,9) With respect to serum sodium concentration (S-Na), various studies in Europe and the United States have demonstrated the effi cacy of TLV to improve hyponatremia with little chance of hypernatremia, ie, S-Na > 145 mEq/L (eg, 1.7% of hypernatremia in the EVEREST study and 0% in the QUEST study). 2,6,[10][11][12] In Japan, we can administer TLV to HF patients to treat their congestion regardless of baseline S-Na as long as hypernatremia or rapid increases in S-Na do not develop. However, no studies have examined the effi cacy and safety of TLV in patients with normonatremia thus far. Therefore, we have analyzed and compared the effect of TLV on S-Na between patients with and witho...

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“…Data are expressed as mean±SEM. protein excretion, we calculated the protein to creatinine ratios to rule out the risk of sample collection error (28)(29)(30)(31). Urinary type IV collagen was measured in a morning urine sample (32,33).…”

Section: Data Procurementmentioning

confidence: 99%

Effect of Renin-Angiotensin-Aldosterone System Triple Blockade on Non-Diabetic Renal Disease: Addition of an Aldosterone Blocker, Spironolactone, to Combination Treatment with an Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker

et al. 2008

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Average urinary excretion of sodium in 24 hours can be estimated from a spot-urine specimen.

Cited by 45 publications

References 16 publications

The influence of posture on the estimation of daily salt intake by the second morning urine method

The influence of posture on the estimation of daily salt intake by the second morning urine method

Urine Sodium Excretion After Tolvaptan Administration Is Dependent Upon Baseline Serum Sodium Levels

Effect of Renin-Angiotensin-Aldosterone System Triple Blockade on Non-Diabetic Renal Disease: Addition of an Aldosterone Blocker, Spironolactone, to Combination Treatment with an Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker

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