Combining urine color and void number to assess hydration in adults and children

Adams, Jennifer; Arnaoutis, Giannis; Johnson, Evan C.; Jansen, Lisa T.; Bougatsas, Dimitris; Jiménez, Catalina Capitán; Mauromoustakos, Andy; Panagiotakos, Demosthenes B.; Perrier, Erica T.; Guelinckx, Isabelle; Kavouras, Stavros A.

doi:10.1038/s41430-020-00834-w

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…Twenty-four hour urine units showed the strongest correlation with TFI ( r 0.67) and Uvol ( r 0.87). Our findings are interesting, since measurement only requires the sum of magnitude of voids during 24 h. The same strategy has recently been used for assessing Ucol directly in lavatories ( 38 ) , and the number of voids is used to assess hydration ( 5 , 14 , 39 ) . In this population, 24 h urine units could be used as an easy proxy for Uvol when volume scaling of urine metabolites is necessary, one urine unit (small void) equalling 124 ml of urine.…”

Section: Discussionmentioning

confidence: 83%

“…Visual Ucol assessment can be biased by individual colour and light perceptions, light conditions, size and depth of urine containers, flavonoids from food, food dyes and drugs ( 16 , 43 , 47 ) . Despite this, Ucol has been shown to correlate strongly with Uosm in several studies ( r 0⋅62–0⋅88) ( 4 , 11 , 16 , 39 ) . We did not find any association between strong coloured food items and atypical Ucol in our study.…”

Section: Discussionmentioning

confidence: 94%

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Estimates of fluid intake, urine output and hydration-levels in women from Somaliland: a cross-sectional study

et al. 2021

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The study objective was to measure fluid intake and associations with background characteristics and hydration biomarkers in healthy, free-living, non-pregnant women aged 15–69 years from Hargeisa city. We also wanted to estimate the proportion of euhydrated participants and corresponding biomarker cut-off values. Data from 136 women, collected through diaries and questionnaires, 24h urine samples and anthropometric measurements, were obtained with a cross-sectional, purposeful sampling from fifty-two school and health clusters, representing approximately 2250 women. The mean (95 % CI) 24 h total fluid intake (TFI) for all women was 2⋅04 (1⋅88, 2⋅20) litres. In multivariate regression with weight, age, parity and a chronic health problem, only weight remained a predictor (P 0.034, B 0.0156 (l/kg)). Pure water, Somali tea and juice from powder and syrup represented 49⋅3, 24⋅6 and 11⋅7 % of TFI throughout the year, respectively. Mean (95 % CI) 24 h urine volume (Uvol) was 1⋅28 (1⋅17, 1⋅39) litres. TFI correlated strongly with 24 h urine units (r 0.67) and Uvol (r 0.59). Approximately 40 % of the women showed inadequate hydration, using a threshold of urine specific gravity (Usg) of 1⋅013 and urine colour (Ucol) of 4. Five percent had Usg > 1⋅020 and concomitant Ucol > 6, indicating dehydration. TFI lower cut-offs for euhydrated, non-breast-feeding women were 1⋅77 litres and for breast-feeding, 2⋅13 litres. Euhydration cut-off for Uvol was 0⋅95 litre, equalling 9⋅2 urine units. With the knowledge of adverse health effects of habitual hypohydration, Somaliland women should be encouraged to a higher fluid intake.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 94%

Estimates of fluid intake, urine output and hydration-levels in women from Somaliland: a cross-sectional study

et al. 2021

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“…Sweat production in young children is indeed considerably less than in adults under similar climatic and activity conditions even when sweating rate is corrected for skin surface area (17) . Our survey does not allow an estimate of any inadequacy as we were not able to measure any morning weight variations nor assess urine volume, colour, number of voids or osmolality (72) . From thirty-two studies on children aged 4-13 years reviewed by Suh et al, only eleven studies reported both water intake and hydration status without assessing the relation between the two (41) .…”

Section: Discussionmentioning

confidence: 99%

Total water intake and its contributors in infants and young children

Chouraqui

Thornton

Seconda³

et al. 2021

Br J Nutr

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Hydration is a particular concern for infants and young children due to their greater risk of dehydration. However, studies on their water intakes are scarce. The current survey aimed to analyze total water intake (TWI) in non-breastfed children aged 0.5-35 months compared to the adequate intake (AI) for the same age group set by the EFSA and to examine the different contributors to TWI as well as beverage consumption patterns. Nationally representative data from the Nutri-Bébé cross-sectional survey were used to assess food, beverage, and plain water consumption by age group over three non-consecutive days. With age, median TWI in 1,035 children increased from 732 to 1010 mL/d, without differences between sex, but with a great inter-individual variation, and the percentage of children who did not meet the AI increased from 10% to 88%. Median weight-related TWI decreased from 136.6 to 69.0 mL/kg/d. Among infants, 90% had a ratio of water/energy below the AI, similarly for about 75% of toddlers. Milk and milk products were the main contributors to TWI, while the part of plain water increased gradually to be 25% in the older toddlers, half of which was tap water. The beverage consumption pattern varied in types and timing, with little consumption of juices and sweetened beverages. Vegetables and fruits accounted for 20% of TWI after the age of 6 months. These initial results, showing strong discrepancies between actual and recommended water intakes in young children, should help identify ways to increase children’s water consumption.

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“…This suggested not to depend on UC in assessing critically ill patients' hydration status as UC alone is not a sufficient tool to assess hydration status. In adults and children, Adams et al (2021) concluded that UC, void numbers and increased urine osmolality/24 hours produce a strong tool in detecting dehydration status. In a physically active population, revealed that UC should be linked with other methods to permit better assessing hydration status.…”

Section: Discussionmentioning

confidence: 99%

Factors Affecting Change of the Urine Color as a Hydration Indicator among Critically Ill Patients

Elsaman

2021

Egyptian Journal of Health Care

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Background: Urine color (UC) is affected by fluid intake and loss from the body. Critically ill patients are exposed to many stressors added to the fluid intake or loss that can disturb body fluids movement affecting the color of the excreted urine. Aim: To assess factors affecting change of the urine color as a hydration indicator among critically ill patients. Design: A descriptive research design was used. Setting: The study was conducted at three general intensive care units in the Teaching Main

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Combining urine color and void number to assess hydration in adults and children

Cited by 7 publications

References 24 publications

Estimates of fluid intake, urine output and hydration-levels in women from Somaliland: a cross-sectional study

Estimates of fluid intake, urine output and hydration-levels in women from Somaliland: a cross-sectional study

Total water intake and its contributors in infants and young children

Factors Affecting Change of the Urine Color as a Hydration Indicator among Critically Ill Patients

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