The assessment of 24 24-h urine volume by measurement of urine specific gravity with dipstick in adults with nephrolithiasis

Khorami, Mohamad Hatef; Hashemi, Rasool; Bagherian-Sararoudi, Reza; Mohammadi Sichani, Merhrdad; Tadayon, Farhad; Shahdoost, Amir Abbas; Arezegar, Sayed Hamid

The assessment of 24 24-h urine volume by measurement of urine specific gravity with dipstick in adults with nephrolithiasis

Authors

¹ Department of Urology, Isfahan University of medical science, Alzahra hospital, Department of urology. Isfahan, Iran

² Department of Psychology, Isfahan University of medical science, Alzahra hospital, Department of urology. Isfahan, Iran Date of Submission 28-Apr-2012 Date of Acceptance 19-Jun-2012 Date of Web Publication 28-Dec-2012

Abstract

Background: Nephrolithiasis is a recurrent disease, and one of the most effective methods for prevention of stone recurrence is increasing the urine output (>2 L/day), but it is difficult to achieve it. The aim of this study was to evaluate the effect of behavioral intervention by measurement of urine specific gravity using dipstick on 24-h urine volume in first renal stone patients.
Materials and Methods: In this prospective randomize clinical study, 80 adult patients with history of first renal stone were included. Patients were divided into two groups with 40 patients in each group. We explained the importance of high fluid intake and high urine volume in the prevention of renal stones for all patients. Group A patients were trained to measure 24-h urine volume every 15 days, and group B patients were trained to keep urine specific gravity below 1.010 by using dipstick. We measured 24-h urine volume in each group before intervention, and at 3 months and 6 months after intervention and compared them.
Results: There were no significant differences between the two groups in 24-h urine volume before intervention (P = 0.41), but it was significant 3 months (P = 0.01) and 6 months (P = 0.01) after intervention. Patients' compliance was 20% in group A and 90% in group B (P < 0.05).
Conclusion: The use of behavioral modification with dipstick is an effective method for control and maintenance of optimal urine volume, and it has resulted in more patient compliance for drinking water and is more effective for prevention of renal stone.

Keywords

References

1.	Glowacki LS, Beecroft ML, Cook RJ, Pahl D, Churchill DN. The natural history of asymptomatic urolithiasis. J Urol 1992;147:319-21. [PUBMED]
2.	Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: A 5-year randomized prospective study. J Urol 1996;155:839-43. [PUBMED]
3.	Borghi L, Schianchi T, Meschi T, Guerra A. Comparison of two diets for the prevention of recurrent stones in idiopathic hypercalciuria. N Engl J Med 2002;346:77-84.
4.	Curhan GC, Willett WC, Speizer FE, Spiegelman D, Stampfer MJ. Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. Ann Intern Med 1997;126:497-504. [PUBMED]
5.	Campbell-Walsh Urology 2012. 10th ed. Imprint of Elsevier. Chapter 45 - Urinary Lithiasis: Etiology, Epidemiology, and Pathogenesis: 2012. p. 520-40.
6.	Tiselius HG. Who forms stones and why? Euro Urol Supp 2011;10:408-14.
7.	Meschi T, Nouvenne A, Borghi L. Lifestyle recommendations to reduce the risk of kidney stones. Urol Clin North Am 2011;38:313-20. [PUBMED]
8.	Fink HA, Akornor JW, Garimella PS, MacDonald R, Cutting A, Rutks IR, et al. Diet, fluid, or supplements for secondary prevention of nephrolithiasis: A systematic review and meta-analysis of randomized trials. Eur Urol 2009;56:72-80. [PUBMED]
9.	Johnson CM, Wilson DM, O'Fallon WM. Renal stone epidemiology: A 25-year study in Rochester, Minnesota. Kidney Int 1979;16:624-31.
10.	Stamatelou KK, Francis ME, Jones CA, Nyberg LM. Time trends in reported prevalence of kidney stones in the United States: 1976-1994. Kidney Int 2003;63:1817-23.
11.	Parivar F, Low RK, Stoller ML. Influence of diet on urinary stone disease. J Urol 1996;155:432-40. [PUBMED]
12.	Atan L, Andreoni C, Ortiz V, Silva EK, Pitta R, Atan F, et al. High kidney stone risk in men working in steel industry at hot temperatures. Urology 2005;65:858-61. [PUBMED]
13.	Curhan GC, Willett WC, Rimm EB, Stampfer MJ. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med 1993;328:833-8. [PUBMED]
14.	Parks JH, Goldfischer ER, Coe FL. Changes in urine volume accomplished by physicians treating nephrolithiasis. J Urol 2003;169:863-6. [PUBMED]
15.	McCormack M, Dessureault J, Guitard M. The urine specific gravity dipstick: A useful tool to increase fluid intake in stone forming patients. J Urol 1991;146:1475-7. [PUBMED]

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