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Accuracy Validation of 8 Equations to Estimate 24-Hour Sodium by Spot Urine in Young Adolescents

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BACKGROUND Several formulas using spot urine have been developed to estimate 24-hour sodium excretion, but none of them have been validated in pediatrics. We aimed to evaluate the performance of… Click to show full abstract

BACKGROUND Several formulas using spot urine have been developed to estimate 24-hour sodium excretion, but none of them have been validated in pediatrics. We aimed to evaluate the performance of 8 formulas-Kawasaki; Tanaka; International Cooperative Study on Salt, Other Factors, and Blood Pressure (INTERSALT1); INTERSALT without potassium (INTERSALT2); Mage; Whitton; Uechi simple-mean; and Uechi regression-in estimating 24-hour sodium excretion at both population and individual levels in Chinese young adolescents. METHODS This cross-sectional study consisted of 284 students aged 10-15 years from Hunan, China. Two spot urine and 24-hour urine samples were collected from each participant. RESULTS The median 24-hour urinary sodium excretion was 2,742 mg. The mean differences (95% confidence intervals) of 24-hour sodium excretion by the 8 equations were 1,613 (1,491 to 1,735) mg for Kawasaki, -12 (-97 to 73) mg for Tanaka, -214 (-319 to -110) mg for INTERSALT1, -289 (-394 to -185) mg for INTERSALT2, -615 (-730 to -500) mg for Mage, 1,082 (967 to 1,198) mg for Whitton, -479 (-610 to -348) mg for Uechi simple-mean, and -620 (-716 to -525) mg for Uechi regression. The Tanaka formula performed best in relative and absolute difference distributions, with 35.2% participants having relative differences within 10%, and 45.8% participants having absolute differences within 393 mg. The misclassification rates were all >50% except for the Tanaka formula (43.7%). CONCLUSIONS In our study, Tanaka could offer a plausible alternative of mean populational 24-hour sodium estimation for young adolescents. However, the results did not support the use of these equations in pediatrics at individual levels.

Keywords: spot urine; sodium; hour; hour sodium; young adolescents

Journal Title: American Journal of Hypertension
Year Published: 2019

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