Creatinine excretion in consecutive urine samples after controlled ingestion of water

Franz, Simon; Skopp, Gisela; Boettcher, Michael; Mußhoff, Frank

doi:10.1002/dta.2514

Cited by 15 publications

(14 citation statements)

References 15 publications

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“…Secondly, specific gravity can be increased due to pathological issues, e.g., proteinuria and glucosuria. 28 Furthermore, in our previous investigation, the specific gravity value in all urine samples did not drop below the cut-off value of 1.003 even at fluid ingestion of 1.5 L. 18 Therefore, Crn may be preferred as dilution marker, and just in case of suspicion, a measurement of Cr and/or specific gravity additionally may be performed.…”

Section: Discussionmentioning

confidence: 72%

“…This result is supported by our previously published water loading study showing similar results (mean 10.9 ± 3.5 mg/dl; n = 18). 18 Additionally, Cone et al…”

Section: Discussionmentioning

confidence: 99%

“…The study design is based on our previously published water loading study 18 . The present study enrolled a total of 18 healthy volunteers (12 women and 6 men, between the ages of 19 and 54 years).…”

Section: Methodsmentioning

confidence: 99%

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The effect of creatine ingestion on urinary creatinine concentration: Does supplementation mask a heavy dilution?

Franz

Skopp

Mußhoff

2021

Drug Testing and Analysis

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A high volume of fluid can strongly reduce a drug's concentration in urine. Therefore, to detect diluted samples, the concentration of creatinine in urine is determined during testing drugs of abuse. If the concentration is below 20 mg creatinine/dl urine, the urine sample is usually rejected for drug testing. It should be examined whether creatine or creatinine ingestion can mask urine dilution by increasing the creatinine concentration. A total of 18 subjects drank 1.3 L of water and 0.2 L of orange juice on each of the three testing days: (1) without creatine, (2) with 20 g of creatine, and (3) with 20 g of creatine following incubation for 4 days in orange juice at room temperature; an acidic environment should promote conversion of creatine to creatinine. The lowest creatinine concentrations in urine were observed on average 2 h after fluid intake. At that time, ingestion of fluid without creatine, with creatine, and with creatine(ine)‐orange juice mixture resulted in mean values of 11.6, 22.5, and 28.3 mg creatinine/dl urine, respectively. It can be concluded that ingestion of creatine or creatinine can increase the concentration of creatinine in urine and thus mask dilution of a sample. The conversion of creatine in orange juice further increases availability of creatinine as it is obvious from urine creatinine concentration. Therefore, creatine ingestion during drug testing will give rise to negative results due to matrix adulteration. In a case of suspected creatine supplementation, the creatine content of the sample should be determined in addition to creatinine.

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Section: Discussionmentioning

confidence: 72%

“…This result is supported by our previously published water loading study showing similar results (mean 10.9 ± 3.5 mg/dl; n = 18). 18 Additionally, Cone et al…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The effect of creatine ingestion on urinary creatinine concentration: Does supplementation mask a heavy dilution?

Franz

Skopp

Mußhoff

2021

Drug Testing and Analysis

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“…Some studies point out that, after a person ingests large amounts of liquids, the concentration of a substance or its metabolites in their urine decreases [40][41][42]. However, we observed when the interviews were being conducted and biological samples were being collected that, among the GSWs, the work routine of the interviewed FSAs hinders frequent departures for drinking water and using the bathroom.…”

Section: Discussionmentioning

confidence: 73%

Evaluation of Exposure to Toluene and Xylene in Gasoline Station Workers

Geraldino

Nunes

Gomes

et al. 2021

Advances in Preventive Medicine

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The main volatile organic compounds found at gasoline stations are benzene, toluene, ethylbenzene, and xylene isomers (BTEX). They cause several harmful effects on human health. Regulatory Norm 7 (1978) provides that, in Brazil, biological monitoring of toluene and xylene is carried out by measuring the urinary metabolites hippuric acid (HA) and methylhippuric acid (MHA), respectively. The objective of this study was to assess the exposure to toluene and xylene and to identify related signs and symptoms in gasoline station workers. A cross-sectional epidemiological study was conducted with workers occupationally exposed to fuels. These gasoline station workers were divided into two groups: 94 workers exposed mainly by inhalation (convenience store workers (CSWs)) and 181 workers exposed by inhalation and dermal route (filling station attendants (FSAs)). A comparison group was formed by 119 workers not occupationally exposed to fuels (office workers (OWs)). Workers exposed to fuels had higher average levels of these exposure biomarkers (HA and MHA), which were also higher in convenience store workers than in filling station attendants. In addition, individuals exposed to the solvents present in gasoline had altered mood/depression, cramps, dizziness, drowsiness, headaches, irritability/nervousness, weakness, weight loss, and other symptoms more frequently and had higher urinary levels of HA and MHA compared to the comparison group. Gasoline station workers showed high levels of HA and MHA, reflecting high occupational exposure to the solvents toluene and xylene present in gasoline, demonstrating that changes in the current legislation and in the work environment are necessary to ensure better health protection for these workers.

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“…Therefore, in light of the above-mentioned findings, clinical urine samples are far too intricate and may contain variables that may interfere with antibody detection due to individual variability in schistosomal glomerulopathy. In addition, highly diluted urine due to water intake is among the most commonly observed factors affecting the validity of urinalysis ( Franz et al, 2019 ). In the future, it may be necessary to collect water ingestion controlled urine samples in order to help decrease the daily fluctuation of concentrations of schistosome-derived substances (such as cell-free DNA and antigens) and specific anti-schistosome antibodies in urine samples, thus potentially increasing agreement with other diagnostic tests for urine-based assays.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic performance of a urine-based ELISA assay for the screening of human schistosomiasis japonica: A comparative study

Weerakoon²,

Olveda³

et al. 2022

Front. Microbiol.

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The current study developed and evaluated the performance of a urine-based enzyme-linked immunosorbent assay (ELISA) for the screening of Schistosoma japonicum infection in a human cohort (n = 412) recruited from endemic areas, Northern Samar, the Philippines. The diagnostic performance of the urine ELISA assay was further compared with the Kato-Katz (KK) technique, serum-based ELISA assays, point-of-care circulating cathodic antigen (POC-CCA) urine cassette test, and droplet digital (dd)PCR assays performed on feces, serum, urine, and saliva samples, which were designated as F_ddPCR, SR_ddPCR, U_ddPCR, and SL_ddPCR, respectively. When urine samples concentrated 16× were assessed, the SjSAP4 + Sj23-LHD-ELISA (U) showed sensitivity/specificity values of 47.2/93.8% for the detection of S. japonicum infection in KK-positive individuals (n = 108). The prevalence of S. japonicum infection in the total cohort determined by the urine ELISA assay was 48.8%, which was lower than that obtained with the F_ddPCR (74.5%, p < 0.001), SR_ddPCR (67.2%, p < 0.001), and SjSAP4 + Sj23-LHD-ELISA (S) (66.0%, p < 0.001), but higher than that determined by the Sj23-LHD-ELISA (S) (24.5%, p < 0.001), POC-CCA assay (12.4%, p < 0.001), and SL_ddPCR (25.5%, p < 0.001). Using the other diagnostic tests as a reference, the urine ELISA assay showed a sensitivity between 47.2 and 56.9%, a specificity between 50.7 and 55.2%, and an accuracy between 49.3 and 53.4%. The concentrated urine SjSAP4 + Sj23-LHD-ELISA developed in the current study was more sensitive than both the KK test and POC-CCA assay, and showed a comparable level of diagnostic accuracy to that of the U_ddPCR. However, its diagnostic performance was less robust than that of the F_ddPCR, SR_ddPCR, and SjSAP4 + Sj23-LHD-ELISA (S) assays. Although they are convenient and involve a highly acceptable non-invasive procedure for clinical sample collection, the insufficient sensitivity of the three urine-based assays (the urine ELISA assay, the U_ddPCR test, and the POC-CCA assay) will limit their value for the routine screening of schistosomiasis japonica in the post mass drug administration (MDA) era, where low-intensity infections are predominant in many endemic areas.

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Creatinine excretion in consecutive urine samples after controlled ingestion of water

Cited by 15 publications

References 15 publications

The effect of creatine ingestion on urinary creatinine concentration: Does supplementation mask a heavy dilution?

The effect of creatine ingestion on urinary creatinine concentration: Does supplementation mask a heavy dilution?

Evaluation of Exposure to Toluene and Xylene in Gasoline Station Workers

Diagnostic performance of a urine-based ELISA assay for the screening of human schistosomiasis japonica: A comparative study

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