Validation of the equations for estimating daily sodium excretion from spot urine in patients with chronic kidney disease
Validation of the equations for estimating daily sodium excretion from spot urine in patients with chronic kidney disease
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DOI：
10.1007/s10157-011-0523-0
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发表时间：
2011-12-01
影响因子：
2.3
通讯作者：
Matsuo, Seiichi
中科院分区：
文献类型：
--
作者：
Imai, Enyu;Yasuda, Yoshinari;Matsuo, Seiichi
测量24小时尿液中的钠排泄量是估计盐摄入量的最可靠方法，但它并不适用于所有患者。作为替代，建立了通过现场尿样估计日本人钠排泄的公式，但这些公式尚未在慢性肾脏病(CKD)患者中得到验证，CKD患者经常与夜尿和药物有关。我们招募了136名CKD患者，收集了24小时尿和第一次晨尿。通过川崎公式和田中公式从第一次早晨的尿液中估算出钠的排泄量，川崎公式最初用于第二次早上的尿液，田中的公式适用于从上午9点到晚上7点的任何时间采集的现场尿样用川崎方程和田中方程计算的BIAS、RMSE分别为48+/-A69和2+/-A69 mmol/day，RMSE和RMSE分别为84和69 mm ol/day，准确度为35%和49%。第一次晨尿NA排泄量用田中公式估算准确，但用川崎公式估算偏高。夜间尿痛及利尿剂、血管紧张素转换酶抑制剂或血管紧张素受体阻滞剂等药物不影响田中公式估算钠排泄量的准确性。田中公式估算慢性肾脏病患者第一次晨尿钠排泄量的准确性足以用于临床实践。
Measuring sodium excretion in a 24-h urine collection is the most reliable method of estimating salt intake, but it is not applicable to all patients. As an alternative, equations for estimating Na excretion from Japanese by a spot urine sample were created, but they have not been validated in patients with chronic kidney disease (CKD), which are frequently associated with nocturia and medication.We enrolled 136 patients with CKD and collected both 24-h urine and the first morning urine. Na excretion was estimated from the first morning urine by Kawasaki's equation, which was originally used for the second morning urine, and Tanaka's equation, which is applied for spot urine samples taken at any time from 9 am to 7 pm. We evaluated the two equations for bias, RMSE and accuracy within 30 and 50% of the measured Na excretion.Bias, RMSE and accuracy within 30% of the estimated Na excretion were 48 +/- A 69 and 2 +/- A 69 mmol/day, 84 and 69 mmol/day, and 35 and 49% using Kawasaki's equation and Tanaka's equation, respectively. Na excretion in the first morning urine was accurately estimated by Tanaka's equation, but it was overestimated by Kawasaki's equation. Nocturia and medication such as diuretics and ACE inhibitor or angiotensin receptor blocker did not affect the accuracy with which Na excretion was estimated by Tanaka's equation substantially.Tanaka's equation for estimating Na excretion from the first morning urine in patients with CKD is accurate enough for use in clinical practice.