Validation of a urine color scale for assessment of urine osmolality in healthy children

Stavros A. Kavouras, Evan C. Johnson, Dimitris Bougatsas, Giannis Arnaoutis, Demosthenes B. Panagiotakos, Erica Perrier, Alexis Klein

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Aim: Urine color (UC) is a practical tool for hydration assessment. The technique has been validated in adults, but has not been tested in children. Purpose: The purpose of the study was to test the validity of the urine color scale in young, healthy boys and girls, as a marker of urine concentration, investigate its diagnostic ability of detecting hypohydration and examine the ability of children to self-assess UC. Methods: A total of 210 children participated (age: 8–14 years, body mass: 43.4 ± 12.6 kg, height: 1.49 ± 0.13 m, body fat: 25.2 ± 7.8 %). Data collection included: two single urine samples (first morning and before lunch) and 24-h sampling. Hydration status was assessed via urine osmolality (UOsmo) and UC via the eight-point color scale. Results: Mean UC was 3 ± 1 and UOsmo 686 ± 223 mmol kg−1. UC displayed a positive relationship as a predictor of UOsmo (R2: 0.45, P < 0.001). Based on the receiver operating curve, UC has good overall classification ability for the three samples (area under the curve 85–92 %), with good sensitivity (92–98 %) and specificity (55–68 %) for detecting hypohydration. The overall accuracy of the self-assessment of UC in the morning or the noon samples ranged from 67 to 78 %. Further threshold analysis indicated that the optimal self-assessed UC threshold for hypohydration was ≥4. Conclusions: The classical eight-point urine color scale is a valid method to assess hydration in children of age 8–14 years, either by researchers or self-assessment.

Original languageEnglish (US)
Pages (from-to)907-915
Number of pages9
JournalEuropean Journal of Nutrition
Volume55
Issue number3
DOIs
StatePublished - Apr 1 2016
Externally publishedYes

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Osmolar Concentration
Color
Urine
Aptitude
Lunch
Area Under Curve
Adipose Tissue
Research Personnel

Keywords

  • Children
  • Dehydration
  • Hydration assessment
  • Hydration status
  • Hypohydration markers

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

Cite this

Kavouras, S. A., Johnson, E. C., Bougatsas, D., Arnaoutis, G., Panagiotakos, D. B., Perrier, E., & Klein, A. (2016). Validation of a urine color scale for assessment of urine osmolality in healthy children. European Journal of Nutrition, 55(3), 907-915. https://doi.org/10.1007/s00394-015-0905-2

Validation of a urine color scale for assessment of urine osmolality in healthy children. / Kavouras, Stavros A.; Johnson, Evan C.; Bougatsas, Dimitris; Arnaoutis, Giannis; Panagiotakos, Demosthenes B.; Perrier, Erica; Klein, Alexis.

In: European Journal of Nutrition, Vol. 55, No. 3, 01.04.2016, p. 907-915.

Research output: Contribution to journalArticle

Kavouras, SA, Johnson, EC, Bougatsas, D, Arnaoutis, G, Panagiotakos, DB, Perrier, E & Klein, A 2016, 'Validation of a urine color scale for assessment of urine osmolality in healthy children', European Journal of Nutrition, vol. 55, no. 3, pp. 907-915. https://doi.org/10.1007/s00394-015-0905-2
Kavouras, Stavros A. ; Johnson, Evan C. ; Bougatsas, Dimitris ; Arnaoutis, Giannis ; Panagiotakos, Demosthenes B. ; Perrier, Erica ; Klein, Alexis. / Validation of a urine color scale for assessment of urine osmolality in healthy children. In: European Journal of Nutrition. 2016 ; Vol. 55, No. 3. pp. 907-915.
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abstract = "Aim: Urine color (UC) is a practical tool for hydration assessment. The technique has been validated in adults, but has not been tested in children. Purpose: The purpose of the study was to test the validity of the urine color scale in young, healthy boys and girls, as a marker of urine concentration, investigate its diagnostic ability of detecting hypohydration and examine the ability of children to self-assess UC. Methods: A total of 210 children participated (age: 8–14 years, body mass: 43.4 ± 12.6 kg, height: 1.49 ± 0.13 m, body fat: 25.2 ± 7.8 {\%}). Data collection included: two single urine samples (first morning and before lunch) and 24-h sampling. Hydration status was assessed via urine osmolality (UOsmo) and UC via the eight-point color scale. Results: Mean UC was 3 ± 1 and UOsmo 686 ± 223 mmol kg−1. UC displayed a positive relationship as a predictor of UOsmo (R2: 0.45, P < 0.001). Based on the receiver operating curve, UC has good overall classification ability for the three samples (area under the curve 85–92 {\%}), with good sensitivity (92–98 {\%}) and specificity (55–68 {\%}) for detecting hypohydration. The overall accuracy of the self-assessment of UC in the morning or the noon samples ranged from 67 to 78 {\%}. Further threshold analysis indicated that the optimal self-assessed UC threshold for hypohydration was ≥4. Conclusions: The classical eight-point urine color scale is a valid method to assess hydration in children of age 8–14 years, either by researchers or self-assessment.",
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AU - Panagiotakos, Demosthenes B.

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