Optimization of urinary dipstick pH: Are multiple dipstick pH readings reliably comparable to commercial 24-hour urinary pH?
| Autor: | Joel E. Abbott, Daniel L. Miller, William Shi, David Wenzler, Fuad F. Elkhoury, Nishant D. Patel, Roger L. Sur |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: | |
| Zdroj: | Investigative and Clinical Urology, Vol 58, Iss 5, Pp 378-382 (2017) |
| Druh dokumentu: | article |
| ISSN: | 2466-0493 2466-054X |
| DOI: | 10.4111/icu.2017.58.5.378 |
| Popis: | Purpose: Accurate measurement of pH is necessary to guide medical management of nephrolithiasis. Urinary dipsticks offer a convenient method to measure pH, but prior studies have only assessed the accuracy of a single, spot dipstick. Given the known diurnal variation in pH, a single dipstick pH is unlikely to reflect the average daily urinary pH. Our goal was to determine whether multiple dipstick pH readings would be reliably comparable to pH from a 24-hour urine analysis.Materials and Methods: Kidney stone patients undergoing a 24-hour urine collection were enrolled and took images of dipsticks from their first 3 voids concurrently with the 24-hour collection. Images were sent to and read by a study investigator. The individ-ual and mean pH from the dipsticks were compared to the 24-hour urine pH and considered to be accurate if the dipstick readings were within 0.5 of the 24-hour urine pH. The Bland-Altman test of agreement was used to further compare dipstick pH relative to 24-hour urine pH.Results: Fifty-nine percent of patients had mean urinary pH values within 0.5 pH units of their 24-hour urine pH. Bland-Altman analysis showed a mean difference between dipstick pH and 24-hour urine pH of -0.22, with an upper limit of agreement of 1.02 (95% confidence interval [CI], 0.45–1.59) and a lower limit of agreement of -1.47 (95% CI, -2.04 to -0.90).Conclusions: We concluded that urinary dipstick based pH measurement lacks the precision required to guide medical manage-ment of nephrolithiasis and physicians should use 24-hour urine analysis to base their metabolic therapy. |
| Databáze: | Directory of Open Access Journals |
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