El-Bokl Mohammed Abdelhamid, Senousy Bahaa Eldeen, El-Karmouty Khaled Zakaria, Mohammed Inas El Khedr, Mohammed Sherif Monier, Shabana Sherif Sadek, Shalaby Hassan
Department of Gastroenterology and Hepatology, Ain Shams University school of Medicine, Abbassia, Cairo, Egypt.
World J Gastroenterol. 2009 Aug 7;15(29):3631-5. doi: 10.3748/wjg.15.3631.
To evaluate the accuracy of spot urinary Na/K and Na/creatinine (Cr) ratios as an alternative to 24-h urinary sodium in monitoring dietary compliance in patients with liver cirrhosis and ascites treated with diuretics.
The study was carried on 40 patients with liver cirrhosis and ascites treated with diuretic therapy. Patients were divided into two groups according to 24-h urinary sodium. We measured spot urine Na/K ratio, Na/Cr ratio and 24-h urinary sodium. Student's t test was used to compare the interval variables and chi(2) test to compare the nominal variables between the two groups. Receiver operator characteristic curve was used to identify the best cutoff point for Na/K and Na/Cr ratio.
The best cutoff point for Na/K ratio was 2.5 (P < 0.001) and area under the curve (AUC) was 0.9, and for Na/Cr ratio, the best cutoff point was 35 (P < 0.001) and AUC was 0.885. Na/K ratio showed higher sensitivity and accuracy compared to Na/Cr ratio (87.5% and 87% for Na/K ratio; 81% and 85% for Na/Cr ratio, respectively).
Spot urine Na/K ratio has adequate accuracy for assessment of dietary sodium restriction compared with 24-h urinary sodium in patients with liver cirrhosis and ascites.
评估随机尿钠/钾和钠/肌酐（Cr）比值作为24小时尿钠替代指标，用于监测肝硬化腹水患者利尿剂治疗期间饮食依从性的准确性。
对40例接受利尿剂治疗的肝硬化腹水患者进行研究。根据24小时尿钠水平将患者分为两组。我们测量了随机尿钠/钾比值、钠/肌酐比值和24小时尿钠。采用学生t检验比较两组间的区间变量，采用卡方检验比较名义变量。采用受试者工作特征曲线确定钠/钾和钠/肌酐比值的最佳截断点。
钠/钾比值的最佳截断点为2.5（P<0.001），曲线下面积（AUC）为0.9；钠/肌酐比值的最佳截断点为35（P<0.001），AUC为0.885。与钠/肌酐比值相比，钠/钾比值显示出更高的敏感性和准确性（钠/钾比值分别为87.5%和87%；钠/肌酐比值分别为81%和85%）。
与24小时尿钠相比，随机尿钠/钾比值在评估肝硬化腹水患者饮食钠限制方面具有足够的准确性。
