Hustrini Ni Made, Siregar Parlindungan, Nainggolan Ginova, Harimurti Kuntjoro
Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Acta Med Indones. 2017 Apr;49(2):112-117.
optimal hydration represents adequate total daily fluid intake to compensate for daily water losses, ensure adequate urine output to reduce the risk of urolithiasis and renal function decline, and also avoid the production of arginine vasopressin (AVP). Twenty-four-hour urine osmolality has been used to assess hydration status, but it is challenging because of the possibility of spilling urine and limitation of daily activities. This study is aimed to determine the performance of the afternoon urine osmolality to assess the optimal hydration status compared with 24-hour urine osmolality.
a cross sectional study was conducted on healthy employees aged 18-59 years at Universitas Indonesia Medical Faculty/Cipto Mangunkusumo Hospital, with consecutive sampling method. The ROC curve was analyzed to obtain the optimal cut off point and the accuracy of the afternoon urine osmolality in assessing the optimal hydration status.
between August-September 2016 there were 120 subjects (73.8% female, median age 32 years) who met the study criteria with a median 24-hour urine osmolality 463.5 (95% CI, 136-1427) mOsm/kg H2O and median afternoon urine osmolality 513 (95% CI, 73-1267). We found moderate correlation (r=0.59; p<0.001) between afternoon urine osmolality and a 24-hour urine osmolality. Using ROC curve, the AUC value was 0.792 (95% CI, 0.708-0.875) with the cut off 528 mOsm/kg H2O. To assess the optimal hydration status, the afternoon urine osmolality had the sensitivity of 0.7 (95% CI, 0.585-0.795) and the specificity of 0.76 (95% CI, 0.626-0.857), Likelihood Ratio (LR) (+) 2.917 (95% CI, 1.74-4.889) and LR (-) 0.395 (95% CI, 0.267-0.583).
afternoon urine osmolality can be used as a diagnostic tool to assess the optimal hydration status in healthy population with cut off 528 mOsm/kg H2O, sensitivity of 0.7, and specificity of 0.76.
最佳水合作用是指每日摄入足够的总液体量，以补偿每日的水分流失，确保有足够的尿量以降低尿路结石和肾功能下降的风险，同时避免精氨酸加压素（AVP）的产生。24小时尿渗透压已被用于评估水合状态，但由于可能出现尿液外洒以及日常活动受限，这一方法具有挑战性。本研究旨在确定与24小时尿渗透压相比，下午尿渗透压评估最佳水合状态的效能。
在印度尼西亚大学医学院/西托·芒古库苏莫医院对18 - 59岁的健康员工进行横断面研究，采用连续抽样方法。分析ROC曲线以获得最佳截断点以及下午尿渗透压评估最佳水合状态的准确性。
2016年8月至9月期间，有120名受试者（73.8%为女性，中位年龄32岁）符合研究标准，24小时尿渗透压中位数为463.5（95%置信区间，136 - 1427）mOsm/kg H₂O，下午尿渗透压中位数为
