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Optimization of urinary dipstick pH: Are multiple dipstick pH readings reliably comparable to commercial 24-hour urinary pH?
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 u...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Urological Association
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577336/ https://www.ncbi.nlm.nih.gov/pubmed/28868511 http://dx.doi.org/10.4111/icu.2017.58.5.378 |
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author | Abbott, Joel E. Miller, Daniel L. Shi, William Wenzler, David Elkhoury, Fuad F. Patel, Nishant D. Sur, Roger L. |
author_facet | Abbott, Joel E. Miller, Daniel L. Shi, William Wenzler, David Elkhoury, Fuad F. Patel, Nishant D. Sur, Roger L. |
author_sort | Abbott, Joel E. |
collection | PubMed |
description | 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 individual 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 management of nephrolithiasis and physicians should use 24-hour urine analysis to base their metabolic therapy. |
format | Online Article Text |
id | pubmed-5577336 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | The Korean Urological Association |
record_format | MEDLINE/PubMed |
spelling | pubmed-55773362017-09-02 Optimization of urinary dipstick pH: Are multiple dipstick pH readings reliably comparable to commercial 24-hour urinary pH? Abbott, Joel E. Miller, Daniel L. Shi, William Wenzler, David Elkhoury, Fuad F. Patel, Nishant D. Sur, Roger L. Investig Clin Urol Original Article 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 individual 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 management of nephrolithiasis and physicians should use 24-hour urine analysis to base their metabolic therapy. The Korean Urological Association 2017-09 2017-07-24 /pmc/articles/PMC5577336/ /pubmed/28868511 http://dx.doi.org/10.4111/icu.2017.58.5.378 Text en © The Korean Urological Association, 2017 http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Abbott, Joel E. Miller, Daniel L. Shi, William Wenzler, David Elkhoury, Fuad F. Patel, Nishant D. Sur, Roger L. Optimization of urinary dipstick pH: Are multiple dipstick pH readings reliably comparable to commercial 24-hour urinary pH? |
title | Optimization of urinary dipstick pH: Are multiple dipstick pH readings reliably comparable to commercial 24-hour urinary pH? |
title_full | Optimization of urinary dipstick pH: Are multiple dipstick pH readings reliably comparable to commercial 24-hour urinary pH? |
title_fullStr | Optimization of urinary dipstick pH: Are multiple dipstick pH readings reliably comparable to commercial 24-hour urinary pH? |
title_full_unstemmed | Optimization of urinary dipstick pH: Are multiple dipstick pH readings reliably comparable to commercial 24-hour urinary pH? |
title_short | Optimization of urinary dipstick pH: Are multiple dipstick pH readings reliably comparable to commercial 24-hour urinary pH? |
title_sort | optimization of urinary dipstick ph: are multiple dipstick ph readings reliably comparable to commercial 24-hour urinary ph? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5577336/ https://www.ncbi.nlm.nih.gov/pubmed/28868511 http://dx.doi.org/10.4111/icu.2017.58.5.378 |
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