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

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Author(s)
Jin Wook LeeJae Seok HwangWoo Jin ChungHeon Ju LeeJung Gil ParkChang Hyeong LeeByung Seok KimJeong Eun SongYoung Oh KweonWon Young TakSoo Young ParkSe Young JangJeong Ill SuhByoung Kuk Jang
Keimyung Author(s)
Hwang, Jae SeokChung, Woo JinJang, Byoung Kuk
Department
Dept. of Internal Medicine (내과학)
Journal Title
PLoS One
Issued Date
2021
Volume
16
Issue
6
Abstract
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.
Keimyung Author(s)(Kor)
황재석
정우진
장병국
Publisher
School of Medicine (의과대학)
Citation
Jin Wook Lee et al. (2021). Diagnostic usefulness of the spot urine sodium/potassium ratio in cirrhotic patients with ascites. PLoS One, 16(6), e0253886. doi: 10.1371/journal.pone.0253886
Type
Article
ISSN
1932-6203
Source
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0253886
DOI
10.1371/journal.pone.0253886
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43652
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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