Validity of Urine Color Scoring Using Different Light Conditions and Scoring Techniques to Assess Urine Concentration

Differences in urine creatinine and osmolality between black and white Americans after accounting for age, moisture intake, urine volume, and socioeconomic status

Urine osmolality is used throughout research to determine hydration levels. Prior studies have found black individuals to have elevated urine creatinine and osmolality, but it remains unclear which factors explain these findings. This cross-sectional, observational study sought to understand the relationship of self-reported race to urine creatinine and urine osmolality after accounting for age, socioeconomic status, and fluid intake. Data from 1,386 participants of the 2009-2012 National Health and Nutrition Examination Survey were utilized. Age, poverty-to-income ratio (PIR), urine flow rate (UFR), fluid intake, estimated lean body mass (LBM), urine creatinine, and urine osmolality were measured. In a sex-specific manner, black and white participants were matched on age, dietary moisture, UFR, and PIR. Urine creatinine was greater in black men (171 mg/dL) than white men (150 mg/dL) and greater in black women (147 mg/dL) than white women (108 mg/dL) (p < .001). Similarly, urine osmolality was greater in black women than white women (723 vs. 656 mOsm/kg, p = .001), but no difference was observed between white and black men (737 vs. 731 mOsm/kg, p = .417). Estimated LBM was greater in black men (61.8 kg) and women (45.5 kg) than in white men (58.9 kg) and women (42.2 kg) (p≤.001). The strongest correlate of urine osmolality in all race-sex groups was urine creatinine (Spearman ρ = .68-.75). These results affirm that individuals identifying as black produce higher urine creatinine concentrations and, in women, higher urine osmolality after matching for age, fluid intake, and socioeconomic status. The findings suggest caution when comparing urine hydration markers between racial groups.

Changes in body mass and hydration status in judo athletes before and after a top-level competition: a descriptive case study

OBJECTIVES

The International Judo Federation (IJF) implemented new regulations in an attempt to regulate rapid weight loss in 2013. The body weight of the athletes cannot be more than 5% higher than the upper limits of their weight categories at the weight check for randomly selected athletes from each weight category before the competition. However, therea lack of studies demonstrating rapid weight loss and hydration status of elite judo athletes in a real match atmosphere under the current refereeing rules. Thus, this study aimed to examine the body mass and hydration changes of elite judo athletes a week before the competition, official weigh-in, and 24 hours after competition.

METHODS

Eight high-level male judo athletes voluntarily participated in this study. Body mass and urinary measures of hydration status were collected a week before, at the official weigh-in and 24-hour post-weigh-in.

RESULTS

The one-way repeated-measures ANOVA showed a significant main effect of time on body mass (p < 0.001). Body mass decreased by 5.4 ± 0.7 kg or 6.8% from a week before the competition to official weigh-in (p < 0.001) and increased by 3.0 ± 1.1 kg or 4.2% from official weigh-in to 24-h post-competition (p < 0.001). A significant effect of time was also found in both urine-specific gravity (USG) (p < 0.001) and urine color (UC) among the measurements (p = 0.001). Athletes' USG values were at the highest level (USG = 1.030 ± 0.001) at the official weigh-in, while they decreased significantly at 24-hour post-competition (USG = 1.017 ± 0.007).

CONCLUSION

The results showed that elite judo athletes resort to rapid weight loss and present dehydration despite established regulations by the IJF.

Urine color expressed in CIE L*a*b* colorspace during rapid changes in hydration status

Background

To investigate how rapid changes in hydration affect urine color expressed in CIE L*a*b* colorspace.

Methods

This study was a two-day crossover design where subjects (N = 30) came in one visit dehydrated, after a 15 h overnight fluid deprivation, and rapidly rehydrated by drinking at least 1000 mL of water in 2 h. On the other visit subjects reported euhydrated and then rapidly dehydrated 2% by walking (3 mph) in a heat chamber (100°F, 50% humidity) for 2 h. Urine samples on both days were collected pre- and post-dehydration/rehydration. Urine osmolality, urine specific gravity, subjective urine color and objective urine color expressed in CIE L*a*b* colorspace were measured.

Results

In the dehydration trial participants experienced a significant weight loss of approximately 2% of their starting, euhydrated body weight. The CIE urine color L*-value significantly decreased (−2.3 units) while the b*-value significantly increased (16 units). Subjective urine color significantly increased (1 unit). Urine osmolality increased (25 mmol/kg) and urine specific gravity increased (0.002 g/mL) between the pre- and post-dehydration conditions, however, neither of these changes were statistically significant. In the rehydration trial participants had a significant 1.5% increase in body weight after the ingestion of water. Significant increases were observed in the CIE urine color L*-value (7 units) and a*-value (1.1 units), while the b*-value significantly decreased (−24 units). Subjective urine color significantly decreased (−3 units). Urine osmolality (−600 mmol/kg) and urine specific gravity (−0.018 g/mL) significantly decreased between the pre- and post-rehydration conditions.

Conclusions

Traditional markers of hydration, including urine osmolality and urine specific gravity, did not significantly change in the acute dehydration trial, suggesting that these values may not be responsive to rapid changes in hydration status. However, the CIE L*- and b*-values of urine color significantly decreased in the rapid dehydration trial and significantly increased in the rapid rehydration trial. Thus, the results of the current study suggest that urine color L*- and b*-values expressed in the CIE L*a*b* colorspace were more responsive to changes in hydration status during rapid dehydration than traditional indices of urine concentration and thus may be better markers under such conditions.

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Rapid dehydration significantly increases both subjective and objective urine color.

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Rapid rehydration significantly decreases both subjective and objective urine color.

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CIE L*a*b* colorspace quantifies urine color to better assess hydration status during rapid dehydration.