Abstract
Aim. The purpose of this pilot study was to examine whether urine specific gravity
and urine colour could provide an early warning of dehydration in stroke patients
compared with standard blood indicators of hydration status.
Background. Dehydration after stroke has been associated with increased blood
viscosity, venous thrombo-embolism and stroke mortality at 3-months. Earlier
identification of dehydration might allow us to intervene to prevent significant
dehydration developing or reduce its duration to improve patient outcomes.
Methods. We recruited 20 stroke patients in 2007 and measured their urine specific
gravity with urine test strips, a refractometer, and urine colour of specimens taken
daily on 10 consecutive days and compared with the routine blood urea:creatinine
ratios over the same period to look for trends and relationships over time. The
agreement between the refractometer, test strips and urine colour were expressed as
a percentage with 95% confidence intervals.
Results. Nine (45%) of the 20 stroke patients had clinical signs of dehydration and
had a significantly higher admission median urea:creatinine ratio (P = 0Æ02, Mann–
Whitney U-test). There were no obvious relationships between urine specific gravity
and urine colour with the urea:creatinine ratio. Of the 174 urine samples collected,
the refractometer agreed with 70/174 (40%) urine test strip urine specific gravity
and 117/174 (67%) urine colour measurements.
Conclusions. Our results do not support the use of the urine test strip urine specific
gravity as an early indicator of dehydration. Further research is required to develop
a practical tool for the early detection of dehydration in stroke patients.
Keywords: acute stroke, complications, dehydration, hydration, urine specific gravity
Abstract
Aim. The purpose of this pilot study was to examine whether urine specific gravity
and urine colour could provide an early warning of dehydration in stroke patients
compared with standard blood indicators of hydration status.
Background. Dehydration after stroke has been associated with increased blood
viscosity, venous thrombo-embolism and stroke mortality at 3-months. Earlier
identification of dehydration might allow us to intervene to prevent significant
dehydration developing or reduce its duration to improve patient outcomes.
Methods. We recruited 20 stroke patients in 2007 and measured their urine specific
gravity with urine test strips, a refractometer, and urine colour of specimens taken
daily on 10 consecutive days and compared with the routine blood urea:creatinine
ratios over the same period to look for trends and relationships over time. The
agreement between the refractometer, test strips and urine colour were expressed as
a percentage with 95% confidence intervals.
Results. Nine (45%) of the 20 stroke patients had clinical signs of dehydration and
had a significantly higher admission median urea:creatinine ratio (P = 0Æ02, Mann–
Whitney U-test). There were no obvious relationships between urine specific gravity
and urine colour with the urea:creatinine ratio. Of the 174 urine samples collected,
the refractometer agreed with 70/174 (40%) urine test strip urine specific gravity
and 117/174 (67%) urine colour measurements.
Conclusions. Our results do not support the use of the urine test strip urine specific
gravity as an early indicator of dehydration. Further research is required to develop
a practical tool for the early detection of dehydration in stroke patients.
Keywords: acute stroke, complications, dehydration, hydration, urine specific gravity
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