Urine Spot Samples Can Be Used to Estimate 24-Hour Urinary Sodium Excretion in Children.

Rios-Leyvraz, Magali; Bovet, Pascal; Tabin, René; Genin, Bernard; Russo, Michel; Rossier, Michel F; Bochud, Murielle; Chiolero, Arnaud (2018). Urine Spot Samples Can Be Used to Estimate 24-Hour Urinary Sodium Excretion in Children. Journal of nutrition, 148(12), pp. 1946-1953. American Society for Nutrition 10.1093/jn/nxy211

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Background

The gold standard to assess salt intake is 24-h urine collections. Use of a urine spot sample can be a simpler alternative, especially when the goal is to assess sodium intake at the population level. Several equations to estimate 24-h urinary sodium excretion from urine spot samples have been tested in adults, but not in children.

Objective

The objective of this study was to assess the ability of several equations and urine spot samples to estimate 24-h urinary sodium excretion in children.

Methods

A cross-sectional study of children between 6 and 16 y of age was conducted. Each child collected one 24-h urine sample and 3 timed urine spot samples, i.e., evening (last void before going to bed), overnight (first void in the morning), and morning (second void in the morning). Eight equations (i.e., Kawasaki, Tanaka, Remer, Mage, Brown with and without potassium, Toft, and Meng) were used to estimate 24-h urinary sodium excretion. The estimates from the different spot samples and equations were compared with the measured excretion through the use of several statistics.

Results

Among the 101 children recruited, 86 had a complete 24-h urine collection and were included in the analysis (mean age: 10.5 y). The mean measured 24-h urinary sodium excretion was 2.5 g (range: 0.8-6.4 g). The different spot samples and equations provided highly heterogeneous estimates of the 24-h urinary sodium excretion. The overnight spot samples with the Tanaka and Brown equations provided the most accurate estimates (mean bias: -0.20 to -0.12 g; correlation: 0.48-0.53; precision: 69.7-76.5%; sensitivity: 76.9-81.6%; specificity: 66.7%; and misclassification: 23.0-27.7%). The other equations, irrespective of the timing of the spot, provided less accurate estimates.

Conclusions

Urine spot samples, with selected equations, might provide accurate estimates of the 24-h sodium excretion in children at a population level. At an individual level, they could be used to identify children with high sodium excretion. This study was registered at clinicaltrials.gov as NCT02900261.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Chiolero, Arnaud

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0022-3166

Publisher:

American Society for Nutrition

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

07 Dec 2018 12:46

Last Modified:

05 Dec 2022 15:22

Publisher DOI:

10.1093/jn/nxy211

PubMed ID:

30517722

BORIS DOI:

10.7892/boris.122330

URI:

https://boris.unibe.ch/id/eprint/122330

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