Walawender Laura, Patterson Jeremy, Strouse Robert, Ketz John, Saxena Vijay, Alexy Emily, Schwaderer Andrew
Pediatric Residency, Nationwide Children's Hospital, Columbus, OH, United States.
User Experience Technology Research and Development, Nationwide Children's Hospital, Columbus, OH, United States.
Front Pediatr. 2018 Jun 6;6:160. doi: 10.3389/fped.2018.00160. eCollection 2018.
Low hydration has a deleterious effect on many conditions. In the absence of a urine concentrating defect, urine concentration is a marker of hydration status. However, markers to evaluate hydration status have not been well studied in children. The objectives of this paper are to compare measures of thirst and urine concentration in children and to develop a novel mobile technology application to measure urine concentration. Children age 12-17 years were selected ( = 21) for this pilot study. Thirst perception, specific gravity (automated dipstick analysis and refractometer), and urine color scale results were correlated to urine osmolality. The technology department developed a mobile technology camera application to measure light penetrance into urine which was tested on 25 random anonymized urine samples. The patients' thirst perception and color scale as well as two researchers color scale did not significantly correlate with osmolality. Correlation between osmolality and hydration markers resulted in the following Pearson coefficients: SG automated dipstick, 0.61 ( 0.003); SG refractometer, 0.98 ( < 0.0001); urine color scale (patient), 0.37 ( 0.10), and light penetrance, -0.77 ( < 0.0001). The correlation of light penetrance with osmolality was stronger than all measures except SG by refractometer and osmolality. The mobile technology application may be a more accurate tool for urine concentration measurement than specific gravity by automated dipstick, subjective thirst, and urine color scale, but lags behind specific gravity measured by refractometer. The mobile technology application is a step toward patient oriented hydration strategies.
低水合状态对多种情况都有有害影响。在没有尿液浓缩功能缺陷的情况下，尿液浓缩是水合状态的一个指标。然而，评估儿童水合状态的指标尚未得到充分研究。本文的目的是比较儿童的口渴程度和尿液浓缩指标，并开发一种新型移动技术应用程序来测量尿液浓缩情况。本试点研究选取了21名12至17岁的儿童。将口渴感知、比重（自动试纸分析和折射仪测量）以及尿色量表结果与尿渗透压进行相关性分析。技术部门开发了一种移动技术相机应用程序，用于测量光线透过尿液的程度，并在25份随机匿名尿液样本上进行了测试。患者的口渴感知和尿色量表以及两名研究人员的尿色量表与渗透压均无显著相关性。渗透压与水合指标之间的相关性得出以下皮尔逊系数：自动试纸法测得的比重为0.61（P<0.003）；折射仪测得的比重为0.98（P<0.0001）；患者尿色量表为0.37（P = 0.10），光线透过率为-0.77（P<0.0001）。除折射仪测得的比重和渗透压外，光线透过率与渗透压的相关性比所有其他指标都强。与自动试纸法测比重、主观口渴程度和尿色量表相比，该移动技术应用程序可能是一种更准确的尿液浓缩测量工具，但落后于折射仪测得的比重。该移动技术应用程序是朝着以患者为导向的水合策略迈出的一步。
