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Petini M, Drigo M, Caldin M, Zoia A. Diagnostic predictivity of transtubular potassium gradient for primary hypoadrenocorticism in hyperkalemic dogs: a cross-sectional study. J Small Anim Pract 2023; 64:434-441. [PMID: 37037658 DOI: 10.1111/jsap.13613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 02/01/2023] [Accepted: 03/05/2023] [Indexed: 04/12/2023]
Abstract
OBJECTIVES Transtubular potassium gradient has never been evaluated in the diagnosis of primary hypoadrenocorticism in dogs. The objective of this study is to evaluate the diagnostic utility of transtubular potassium gradient for the diagnosis of primary hypoadrenocorticism in dogs with serum K+ > 5.5 mol/L. MATERIALS AND METHODS Cross-sectional study including dogs with primary hypoadrenocorticism and dogs with other disease. Differences in signalment and laboratory parameters between groups were assessed by binary logistic regression modelling. Variables significantly associated with primary hypoadrenocorticism were evaluated for their diagnostic accuracy of this condition by receiver operator characteristic curve analysis and by multivariable logistic regression analysis, respectively. RESULTS Dogs with primary hypoadrenocorticism (n=39) were significantly younger than hyperkalemic dogs without primary hypoadrenocorticism (n=41). Moreover they had higher serum and urinary concentrations of Na+ and Na+ :K+ , but lower transtubular potassium gradient than hyperkalemic dogs without hypoadrenocorticism. Serum Na+ (sNa+ ) had the highest diagnostic accuracy (area under the curve [AUC]: 0.87, 95% confidence interval, 0.78 to 0.96), followed by the transtubular potassium gradient (AUC: 0.81, 0.72 to 0.91), however the accuracy of the two AUCs was not statistically different. The transtubular potassium gradient-sNa+ additive index (i.e. transtubular potassium gradient+sNa+ /10) had a greater accuracy (AUC: 0.88, 0.79 to 0.94) than transtubular potassium gradient or sNa+ , although it was not statistically superior to the latter. The multivariable logistic regression model showed that transtubular potassium gradient (adjusted odds ratio [aOR]: 0.51, 0.3 to 0.84), sNa+ (aOR: 0.86, 0.78 to 0.95) and spayed female (aOR: 24.96, 2.32 to 267.66) were associated with primary hypoadrenocorticism. CLINICAL SIGNIFICANCE Transtubular potassium gradient-sNa+ additive index can contribute to decision-making on diagnosis of primary hypoadrenocorticism in dogs presenting with hyperkalaemia.
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Affiliation(s)
- M Petini
- Division of Internal Medicine, San Marco Veterinary Clinic, Via dell'Industria 3, Veggiano, Italy
| | - M Drigo
- Department of Animal Medicine, Production and Health, University of Padova, V.le dell'Università 16, 35020, Legnaro, Italy
| | - M Caldin
- San Marco Veterinary Laboratory, Via dell'Industria 3, Veggiano, Italy
| | - A Zoia
- Division of Internal Medicine, San Marco Veterinary Clinic, Via dell'Industria 3, Veggiano, Italy
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Raj J, Sanchez Lara A, Bell R, Tappin S. Canine isolated hypoaldosteronism. VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.29] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- Jennifer Raj
- Small Animal Internal Medicine Dick White Referrals Ltd Six Mile Bottom Cambridgeshire UK
| | | | - Rory Bell
- Small Animal Internal Medicine Dick White Referrals Ltd Six Mile Bottom Cambridgeshire UK
| | - Simon Tappin
- Small Animal Internal Medicine Dick White Referrals Ltd Six Mile Bottom Cambridgeshire UK
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Yoo DW, Lee SM, Moon SY, Kim IS, Chang CL. Evaluation of conductivity-based osmolality measurement in urine using the Sysmex UF5000. J Clin Lab Anal 2020; 35:e23586. [PMID: 32969530 PMCID: PMC7843274 DOI: 10.1002/jcla.23586] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 11/21/2022] Open
Abstract
Background Automated flow cytometry‐based urine analyzer is increasingly being used to identify and enumerate cells and particles in urine specimens. It measures electrical conductivity which could be transformed to osmolality. Using this machine, all urine specimens could be screened for osmolality without requiring a separate dedicated device. We evaluated the performance of the new instrument, the UF‐5000 (Sysmex Corporation), in the measurement of urine osmolality. Methods The precision of urine osmolality measurement by the UF‐5000 was evaluated for 20 days and 4 times a day for 2 concentrations. The linearity and detection capability were evaluated according to the Clinical and Laboratory Standards Institute guidelines. For comparison, 270 random urine specimens from patients were tested simultaneously using the UF5000 and the OsmoPro micro‐osmometer (Advanced instruments). Results The laboratory‐based coefficient variations were less than 5%. Urine osmolality using the UF‐5000 has a verified linear range (y = 1.097x + 16.91, R2 = .997). Within the comparison analysis, the mean difference was not large (−7.72%) but each differences were largely dispersed with 95% limits of agreement (LoA) from −70.5 to 55.06%, and the mean absolute difference −28.3 mOsm/kg with 95% LoA from −295.13 to 238.45 mOsm/kg. Cohen's kappa value was 0.54 (95% CI, 0.45‐0.63). Conclusions The UF‐5000 measured conductivity and generated an acceptable quantitative analysis of urine osmolality. When compared with the results of the freezing point depression method used by the OsmoPro, a percentage of the measured urine osmolality by the UF‐5000 was outside the allowable limit.
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Affiliation(s)
- Dong-Won Yoo
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Laboratory Medicine, Pusan National University Hospital, Busan, South Korea.,Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - Sun Min Lee
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - Soo Young Moon
- Department of Laboratory Medicine, Pusan National University Hospital, Busan, South Korea.,Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - In-Suk Kim
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea
| | - Chulhun L Chang
- Department of Laboratory Medicine and Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, South Korea.,Department of Laboratory Medicine, Pusan National University School of Medicine, Busan, South Korea
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Oyaert M, Speeckaert MM, Delanghe JR. Estimated urinary osmolality based on combined urinalysis parameters: a critical evaluation. Clin Chem Lab Med 2020; 57:1169-1176. [PMID: 30753156 DOI: 10.1515/cclm-2018-1307] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 01/21/2019] [Indexed: 01/05/2023]
Abstract
Background Urinary conductivity allows a coarse prediction of urinary osmolality in most cases but is insensitive to the osmolal contribution of uncharged particles and the presence of roentgen contrast media. Urinary osmolality can be estimated on the recently introduced Sysmex UF-5000 urine analyzer using conductivity. In this study, we evaluated the analytical performance of this research parameter. Secondly, we aimed to improve the manufacturer's algorithm for estimating urinary osmolality, based on standard urinalysis parameters (creatinine, glucose, relative density). Methods The analytical performance was determined and a prediction model to estimate urinary osmolality based on urinalysis parameters was developed. We further developed and validated a prediction model using another set of routine urine samples. In addition, the influence of roentgen contrast media on urinary osmolality was studied. Results The within-run and between imprecision for osmolality and conductivity measured on the Sysmex UF-5000 ranged from 1.1% to 4.9% and 0.7% to 4.8%, respectively. Multiple regression analysis revealed urinary creatinine, conductivity and relative density to be the strongest predictors to estimate urinary osmolality. A mean difference of 1.3 mOsm/kg between measured and predicted osmolality demonstrated that the predictive performance of our model was favorable. An excellent correlation between the relative density and % contrast media was demonstrated. Conclusions Urinary osmolality is an important parameter for assessing specimen dilution in urinalysis. Urinary conductivity, along with relative density and urinary creatinine allows a coarse prediction of urinary osmolality and is insensitive to the osmolal contribution of uncharged particles and the presence of roentgen contrast media.
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Affiliation(s)
- Matthijs Oyaert
- Department of Laboratory Medicine, University Hospital Ghent, Ghent, Belgium
| | | | - Joris R Delanghe
- Department of Laboratory Medicine, University Hospital Ghent, Ghent, Belgium
- Department of Clinical Chemistry, Ghent University, C. Heymanslaan 10, 9000 Ghent, Belgium
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Yam E, Boyd CJ, Hosgood G, Claus MA, Raisis AL, Sharp CR, Smart L. Hydroxyethyl starch 130/0.4 (6%) and succinylated gelatine (4%) interfere with refractometry in dogs with haemorrhagic shock. Vet Anaesth Analg 2019; 46:579-586. [PMID: 31401048 DOI: 10.1016/j.vaa.2019.05.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 03/21/2019] [Accepted: 05/03/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To determine if low molecular weight synthetic colloid fluids administered to dogs interfere with refractometric estimates of total plasma protein (TPPr) and urine osmolality (UOsm). STUDY DESIGN Experimental study. ANIMALS Eighteen healthy Greyhound dogs. METHODS Anaesthetized Greyhounds subjected to haemorrhage for 60 minutes were given 80 mL kg-1 of Plasma-Lyte 148 (CRYST), or 20 mL kg-1 of hydroxyethyl starch 130/0.4 (HES) or succinylated gelatine (GELO) (n = 6 per group) intravenously over 20 minutes. Refractometric (TPPr) and biuret total plasma protein (TPPb) were measured before haemorrhage (Baseline), at end of shock (Shock), immediately (T20), then 40 minutes (T60), 100 minutes (T120) and 160 minutes (T180) after fluid administration. Urine specific gravity (USG) and UOsm were measured at all time points except T20. Estimated UOsm (eUOsm) was calculated from USG. Bias and limits of agreement (LOA) for TPPr versus TPPb, and eUOsm versus UOsm were calculated at each time point. RESULTS For dogs given CRYST and GELO, median TPPr and TPPb decreased in parallel, with a small consistent TPP bias (CRYST range of bias, 0.38-0.67 g dL-1; GELO range of bias, 0.42-0.58 g dL-1). Dogs given HES showed divergence between median TPPr and TPPb after T20, with a peak bias at T20 of 1.62 g dL-1 (LOA 1.29-1.95). Dogs given HES and GELO had markedly increased USG [HES peak median USG at T180 of 1.119 (Q1-Q3 1.103-1.122); GELO peak median USG at T120 of 1.114 (Q1-Q3 1.082-1.119)], with large increases in bias between eUOsm and UOsm [HES peak bias at T60 of 2995 mOsm kg-1 (LOA 2032-3958 mOsm kg-1); GELO peak bias at T120 of 2465 mOsm kg-1 (LOA 940-3990 mOsm kg-1)]. CONCLUSIONS AND CLINICAL RELEVANCE Administration of HES and GELO to dogs with haemorrhagic shock interferes with refractometric measurements for at least 3 hours after administration.
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Affiliation(s)
- Elodie Yam
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Corrin J Boyd
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Giselle Hosgood
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Melissa A Claus
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Anthea L Raisis
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Claire R Sharp
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia
| | - Lisa Smart
- Comparative Health Research Group, School of Veterinary and Life Sciences, Murdoch University, WA, Australia.
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Zanghi BM, Gardner CL. Total Water Intake and Urine Measures of Hydration in Adult Dogs Drinking Tap Water or a Nutrient-Enriched Water. Front Vet Sci 2018; 5:317. [PMID: 30619899 PMCID: PMC6305449 DOI: 10.3389/fvets.2018.00317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 11/29/2018] [Indexed: 11/16/2022] Open
Abstract
Water intake and urine measures were evaluated in dogs offered tap water (TW) or a nutrient-enriched water (NW) supplement while fed dry food with ad libitum TW in a bucket. Baseline (day-7) urine specific gravity (USG) was analyzed from healthy, adult small breed dogs (n = 21; 2-11 years). Dogs (N = 16) were selected with ≥1.015 USG, then equally divided into 2 groups balanced for USG. Groups received either TW or NW in a bowl for 56 days. Dose for each dog was 0.5:1 water-to-calorie ratio (mL:kcal ME/d) from days 1-49 to evaluate sustained intake of a moderate volume, or 2:1 water-to-calorie ratio from days 50-56 to evaluate short-term intake of a large volume, based on baseline food calorie intake. Daily food calorie and total liquid intake (TLI; g/d; sum of NW or TW in a bowl and bucket water) was used to calculate weekly intake. USG was measured on days -7, 14, 42, 56. Calorie intake was not different (P > 0.49). A significant (P < 0.001) time-by-treatment interaction resulted for TLI with baseline similar between groups and no difference between weeks for the TW group. Following baseline, NW group had increased (P < 0.05) TLI every week, except for week 2 (P = 0.07). A significant (P < 0.002) time-by-treatment interaction resulted for USG, with baseline similar between groups and no difference between sampling days for the TW group (varied by ≤ 0.006 g/mL), whereas NW group was lower (P < 0.01) on days 42 (1.018 g/mL) and 56 (1.014 g/mL) vs. baseline (1.026 g/mL). This study indicates that all dogs offered the NW supplement increased their TLI and produced a more dilute urine, which suggests an improvement in indices associated with chronic hydration.
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