Comparative study of spot urine Na/K ratio and 24-hour urine sodium in natriuresis evaluation of cirrhotic patients with ascites

Silva, Otávio Marcos da; Thiele, G; Fayad, Leonardo; Lazzarotto, César; Dantas-Corrêa, Esther Buzaglo; Schiavon, Leonardo de Lucca; Narciso-Schiavon, Janaína Luz

doi:10.1016/j.jpg.2013.04.006

Cited by 6 publications

(11 citation statements)

References 17 publications

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Section: Discussioncontrasting

confidence: 94%

“…Moreover, the AUROC curve was 0.874 ± 0.051 (P<0.001). The spot urine Na/K ratio reflects 24-h urine Na, but the AUROC value in this study is lower than those of the previous studies [17][18][19]. Since 1996, Runyon et al [20] has reported an abstract on the association between the spot urine Na/K ratio and 24-h urine Na, and several studies reported the diagnostic value of the spot urine Na/K ratio.…”

Section: Discussioncontrasting

confidence: 72%

“…Currently, the American Association for the Study of Liver Diseases recommended a cutoff value of 1 for the spot urine Na/K ratio [12]. Moreover, previous studies showed sensitivity of 81%-95.5%, specificity of 58.3%-92%, and AUROC value of 0.861-0.948 when the spot urine Na/K ratio was 1 [16][17][18][19]. Spot urine Na/K ratio is being used in actual clinical practice.…”

Section: Discussionmentioning

confidence: 99%

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Diagnostic usefulness of the spot urine sodium/potassium ratio in cirrhotic patients with ascites

Lee

Chung

Lee³

et al. 2021

PLoS ONE

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Background and aims The low-salt diet is considered important for control of ascites in cirrhotic patients. To validate whether the spot urine sodium (Na)/potassium (K) ratio could replace 24-h urine Na (uNa) excretion in assessing low-salt diet compliance. Methods We prospectively studied 175 patients. 24-h urine collection and spot urine collection were performed. Subsequently, 24-h uNa, urine creatinine (uCr), and spot urine Na and K were assessed. A complete urine collection was confirmed based on 24-h uCr excretion levels of 15mg/kg/day for men and 10mg/kg/day for women. The area under the receiver operating characteristic (AUROC) curve analysis was performed to evaluate the feasibility of spot urine Na/K ratio in predicting 24-h uNa greater than 78mmol/day. Results Out of 175 patients, 24-h urine samples were completely collected in 57 patients only. Moreover, urine samples were not completely collected in 118 patients because their 24-h uCr excretion level was less than the established criteria. In complete urine collection group, AUROC curve for spot urine Na/K ratio in predicting 24-h uNa greater than 78mmol/day was 0.874±0.051 (P<0.001). In the incomplete urine collection group, the AUROC was 0.832±0.039 (P<0.001). In complete urine collection group, the classical cutoff value greater than 1.0 of spot urine Na/K ratio showed 90.9% sensitivity and 56.0% specificity. Conclusions The spot urine Na/K ratio reflects 24-h uNa, but the AUROC value obtained in this study is lower than that of a previous study. Considered the large number of patients with incomplete urine collection, validating 24-h complete urine collection criteria is necessary.

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Section: Discussioncontrasting

confidence: 94%

Section: Discussioncontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

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Diagnostic usefulness of the spot urine sodium/potassium ratio in cirrhotic patients with ascites

Lee

Chung

Lee³

et al. 2021

PLoS ONE

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“…In our study, the minimum 24UNa was 87.1 mEq and the minimum urinary Na/K of the second-void urine of the first day was 1.45. Although we performed this trial with healthy people, the result corresponded with a previous report on hypertensive patients [28]. Based on their own studies for hypertensive and healthy normotensive subjects, Iwahori et al [21,22,29] have suggested that the urinary Na/K ratio could be a robust monitoring tool for Na reduction and K increase in the normal population, as well as for patients during treatment.…”

Section: Discussionsupporting

confidence: 84%

“…A further advantage of the urinary Na/K ratio was to determine whether patients consumed a low salt diet or not. If the urinary Na/K ratio was equal to or higher than 1 in patients with liver cirrhosis with ascites, the probability that random spot urine Na concentration was over 78 mEq was 90 to 95 percent [28]. In our study, the minimum 24UNa was 87.1 mEq and the minimum urinary Na/K of the second-void urine of the first day was 1.45.…”

Section: Discussionmentioning

confidence: 46%

Development of objective indicators for quantitative analysis of sodium intake: the sodium to potassium ratio of second-void urine is correlated with 24-hour urinary sodium excretion

Kim

Han

et al. 2020

Nutr Res Pract

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BACKGROUND/OBJECTIVES: To date, sodium intake has been evaluated based on spot urine instead of 24-hour (hr) urine collection. Nevertheless, the optimal method for assessing daily sodium intake remains unclear. SUBJECTS/METHODS: Fifteen male (age 32.7 ± 6.5 years) participants were offered 3 meals with a total of 9-10 g salt over 24 hours, and 24-hr urine was collected from the second-void urine of the first day to the first-void urine of the second day. Twenty-four-hr urinary sodium (24UNa) was estimated using Tanaka's equation and the Korean formula, and spot urine Na, potassium (K), chloride (Cl), urea nitrogen (UN), creatinine (Cr), specific gravity (SG) and osmolality (Osm) were measured. The ratios of urinary Na to other parameters were calculated, and correlations with total measured 24UNa were identified. RESULTS: Average 24-hr urine volume was 1,403 ± 475 mL, and measured 24UNa was 143.9 ± 42.1 mEq (range, 87.1-239.4 mEq). Measured 24UNa was significantly correlated with urinary Na/UN

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Association of serum sodium and 24-hour urinary sodium level with the severity and complications of ascites in cirrhotic patients

Islam,

Ghosh,

Hamid

et al. 2023

Medicine

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Hyponatremia is an independent predictor of mortality in cirrhotic patients but little is known regarding the relationship between the level of serum sodium and 24-hour urinary sodium with the development of severity and complications of cirrhotic ascites. To observe the association of serum sodium and 24-hour urinary sodium levels with different grades of ascites and its complications in cirrhotic patients. In the department of Gastroenterology in a tertiary care hospital, this cross-sectional study was conducted from April 2019 to September 2020. A total of 96 admitted cirrhotic patients with ascites were enrolled in this study by consecutive sampling. Out of 96 patients with cirrhotic ascites, 48 patients had mild, moderate, and severe ascites and 48 patients had complications of ascites like refractory ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome. The mean serum sodium level was 131.69 ± 4.90 and 124.88 ± 5.67 mmol/L and the 24-hour urinary sodium level was 76.82 ± 45.64 and 35.26 ± 22.57 mmol/L in uncomplicated and complicated ascites groups respectively with P value < .001. In grade 1, grade 2, and grade 3 ascites, there was a significant (P = .001), association between mean serum sodium (mmol/L) level (R −0.777) and 24-hour urine sodium (mmol/L) level (R −0.704) but no significant difference was seen when refractory ascites, spontaneous bacterial peritonitis, and hepatorenal syndrome were considered. In our finding, low serum sodium and low 24-hour urinary sodium levels were associated with the development of severe complications of cirrhotic ascites. Hence, Serum sodium and 24-hour urinary sodium levels can be good predictors of grading and complications of cirrhotic ascites.

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Comparative study of spot urine Na/K ratio and 24-hour urine sodium in natriuresis evaluation of cirrhotic patients with ascites

Cited by 6 publications

References 17 publications

Diagnostic usefulness of the spot urine sodium/potassium ratio in cirrhotic patients with ascites

Diagnostic usefulness of the spot urine sodium/potassium ratio in cirrhotic patients with ascites

Development of objective indicators for quantitative analysis of sodium intake: the sodium to potassium ratio of second-void urine is correlated with 24-hour urinary sodium excretion

Association of serum sodium and 24-hour urinary sodium level with the severity and complications of ascites in cirrhotic patients

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