The optimal range of sodium intake for cardiovascular health is controversial.
We obtained morning fasting urine samples from 101,945 persons in 17 countries and estimated 24-hour sodium and ...potassium excretion (used as a surrogate for intake). We examined the association between estimated urinary sodium and potassium excretion and the composite outcome of death and major cardiovascular events.
The mean estimated sodium and potassium excretion was 4.93 g per day and 2.12 g per day, respectively. With a mean follow-up of 3.7 years, the composite outcome occurred in 3317 participants (3.3%). As compared with an estimated sodium excretion of 4.00 to 5.99 g per day (reference range), a higher estimated sodium excretion (≥ 7.00 g per day) was associated with an increased risk of the composite outcome (odds ratio, 1.15; 95% confidence interval CI, 1.02 to 1.30), as well as increased risks of death and major cardiovascular events considered separately. The association between a high estimated sodium excretion and the composite outcome was strongest among participants with hypertension (P=0.02 for interaction), with an increased risk at an estimated sodium excretion of 6.00 g or more per day. As compared with the reference range, an estimated sodium excretion that was below 3.00 g per day was also associated with an increased risk of the composite outcome (odds ratio, 1.27; 95% CI, 1.12 to 1.44). As compared with an estimated potassium excretion that was less than 1.50 g per day, higher potassium excretion was associated with a reduced risk of the composite outcome.
In this study in which sodium intake was estimated on the basis of measured urinary excretion, an estimated sodium intake between 3 g per day and 6 g per day was associated with a lower risk of death and cardiovascular events than was either a higher or lower estimated level of intake. As compared with an estimated potassium excretion that was less than 1.50 g per day, higher potassium excretion was associated with a lower risk of death and cardiovascular events. (Funded by the Population Health Research Institute and others.).
Majority of automated instruments are validated and verified for serum and urine chemistry parameters. However, manufacturers do not provide performance verification for body fluids. Since body ...fluids such as ascitic, pleural, CSF, dialysate and pericardial fluid specimens form a part of testing panel for variety of analytes, it becomes important to verify/validate the performance of these fluids. The accreditation bodies that certify and accredit labs follow ISO 15189:2012 that states validation should be carried out whenever there is a deviation from stated procedure. The aim of this study was to establish performance characteristics for commonly requested analytes in body fluids. Left over samples were utilised for validation/verification of ten common analytes specific to each of the above-mentioned body fluids on Abbott Architect ci8222 integrated system. Performance characteristics that were verified are as follows: Imprecision, accuracy, reportable range, stability and interference. Assay imprecision for body fluid assays were comparable to imprecision obtained for serum. Accuracy was evaluated with recovery experiment after spiking the sample with a known concentration of substance. Reportable range was found to be comparable to serum parameters. Chemistry analytes for body fluid analytes was found to be stable for a period of 20 days at -20degrees C. It is mandatory for lab to establish validation/verification of body fluid assays for commonly requested analytes. This would improve the reliability of the testing system.
Although 24-h urinary measure to estimate sodium and potassium excretion is the gold standard, it is not practical for large studies. We compared estimates of 24-h sodium and potassium excretion from ...a single morning fasting urine (MFU) using three different formulae in healthy individuals.
We studied 1083 individuals aged 35-70 years from the general population in 11 countries. A 24-h urine and MFU specimen were obtained from each individual. A subset of 448 individuals repeated the measures after 30-90 days. The Kawasaki, Tanaka, and INTERSALT formulae were used to estimate urinary excretion from a MFU specimen.
The intraclass correlation coefficient (ICC) between estimated and measured sodium excretion was higher with Kawasaki (0.71; 95% confidence interval, CI: 0.65-0.76) compared with INTERSALT (0.49; 95% CI: 0.29-0.62) and Tanaka (0.54; 95% CI: 0.42-0.62) formulae (P <0.001). For potassium, the ICC was higher with the Kawasaki (0.55; 95% CI: 0.31-0.69) than the Tanaka (0.36; 95% CI: -0.07 to 0.60; P <0.05) formula (no INTERSALT formula exists for potassium). The degree of bias (vs. the 24-h urine) for sodium was smaller with Kawasaki (+313 mg/day; 95% CI: +182 to +444) compared with INTERSALT (-872 mg/day; 95% CI: -728 to -1016) and Tanaka (-548 mg/day; 95% CI: -408 to -688) formulae (P <0.001 and P = 0.02, respectively). Similarly for potassium, the Kawasaki formula provided the best agreement and least bias. Blood pressure correlated most closely and similarly with the 24-h and Kawasaki estimates for sodium compared with the other two formulae.
In a diverse population, the Kawasaki formula is the most valid and least biased method of estimating 24-h sodium excretion from a single MFU and is suitable for population studies.
Background: Phlebotomy or drawing of blood sample is one of the initial steps in processing of samples for various investigations of the patients in clinical laboratory. The sample for various ...investigation has to follow certain protocol or order of blood draw into different vacutainers by phlebotomist or the clinical person drawing the blood to avoid errors in test results. Hence awareness of order of blood draw among them is very essential.Methods: It is a cross sectional and observational study. Based on CLSI H3-A6 (clinical and laboratory standards institute) guidelines, a questionnaire consisting of 13 multiple choice questions was prepared after validation and distributed amongst the nurses, who were on duty during the study. The answers to the questionnaire were analysed using SPSS version 23. Descriptive statistics was done for all the data collected.Results: Total 120 nurses participated in this study in a tertiary care hospital. Nurses who were able to identify Color of the vacutainer with respective to additives (90%), correct order of draw (52%), volume of blood sample collected in vacutainer (62.9%), sample collected directly into vacutainer with vacuum suction (61.7%) was incomplete. Nurses also had wrong practices, where sample was transferred from one vacutainer to other (3.3%), collected the blood sample from the arm which had IV line (28%).Conclusions: In this study, it was found that awareness on the level of order of blood draw among nurses was found unsatisfactory. Frequent training and monitoring of work practices should be developed for nurses to reduce the errors in sample collection.
Can Sample Type Affect Vitamin D Concentration? Prakash, Shubha N; Devanath, Anitha; Jayakumari, S ...
Indian Journal of Medical Biochemistry,
08/2020, Volume:
24, Issue:
1
Journal Article
24 hours traditional urine collection method is cumbersome and tedious process with less patient compliance. Our study proposes a novel fractional urine collection method for protein estimation that ...would entail collection of small volumes of urine each time patient voids Over 24h Period. Our aim was to compare urine protein in proposed method versus traditional 24hour sampling method.
Cross-sectional, prospective study was a collaborative work between Departments of Nephrology and Biochemistry in our tertiary care hospital. Volunteers (48) and Chronic Kidney disease subjects (52) were recruited. Out of which, 76 subjects were selected. Novel method was compared with conventional method in each of these groups, before and after centrifugation and with and without preservative. Intraclass correlation coefficient (ICC) and Bland Altman analysis was used to evaluate for agreement between the two methods.
All the values were combined without categorization into subgroups. Fractional urine collection method (before centrifugation) without preservative (F1) and with preservative (F2) was compared to conventional method, ICC was 0.93 (C.I, 0.9 to 0.95) and 0.96 (C.I, 0.94 to 0.97) respectively. After centrifugation, fractional urine collection method for F1and F2 versus conventional method, ICC was 0.95 (C.I, 0.92 to 0.97) and 0.91 (C.I, 0.86 to 0.94) respectively.
The novel collection method is comparable and reliable as traditional 24-hour method. The use of thymol as preservative leads to negative interference and centrifugation is mandatory before urine analysis. With proper sampling, urine protein by novel method has a good agreement with the conventional technique.
PDF
