• Title/Summary/Keyword: urine osmolality

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First-morning urine osmolality changes in children with nocturnal enuresis at the end of treatment

  • Yun Ha Lee;Jae Min Chung;Sang Don Lee
    • Childhood Kidney Diseases
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    • v.28 no.1
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    • pp.27-34
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    • 2024
  • Purpose: The ability to concentrate urine becomes an important index in determining nocturnal enuresis (NE) treatment. The aim of our study was to investigate first-morning urine osmolality (Uosm) changes at the end of treatment compared to before treatment in children with NE. Methods: A total of 71 children with NE were divided into two groups according to the level of first-morning Uosm before treatment: high group (≥800 mOsm/kg) and low group (<800 mOsm/kg). Baseline parameters were obtained from uroflowmetry, frequency volume charts for at least 2 days, and a questionnaire for lower urinary tract symptoms. All patients were basically treated with standard urotherapy and medication. The first-morning Uosm was measured twice, before treatment and at the end of treatment. Results: The response rate was higher in the low group after 3 months of treatment than in the high group (P=0.041). However, there was no difference between the two groups at the end of the treatment. In the high group, the first-morning Uosm at the end of treatment did not show a significant change compared to before treatment. In contrast, the first-morning Uosm increased in the low group at the end of treatment (P<0.001). However, it was still lower than that of the high group (P=0.007). Conclusions: The ability to concentrate nocturnal urine improved at the end of treatment compared to before treatment in the low Uosm NE children. In addition, NE improved faster in the low Uosm group before treatment than in the high group.

A Rare Case of Hyponatremia Caused by Reset Osmostat in a Neonate with Cleft Lip, Cleft Palate, and Imperforate Anus

  • Ahn, Jung Gu;Lee, Jeong Eun;Chung, Woo Yeong;Koo, Soo Hyun;Shin, Jaeho;Jeon, Ga Won
    • Neonatal Medicine
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    • v.25 no.3
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    • pp.131-135
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    • 2018
  • Hyponatremia is defined as a plasma sodium concentration of <135 mEq/L. It is a common electrolyte imbalance in newborns. We report the case of a term neonate with cleft lip, cleft palate, imperforate anus, normal male karyotype, and chronic hyponatremia. On the 4th day of life, he showed hyponatremia (plasma sodium concentration 130 mEq/L) with low serum osmolality (275 mOsm/kg), high urine sodium (116.7 mEq/L), and high urine osmolality (412 mOsm/kg). His thyroid and adrenal functions were normal. Despite intravenous and oral sodium supplementation and hydrocortisone treatment, hyponatremia persisted. Brain magnetic resonance imaging showed normal results. He was diagnosed as having reset osmostat, a rare subtype of the syndrome of inappropriate secretion of antidiuretic hormone characterized by a subnormal threshold for antidiuretic hormone secretion, with hypotonic hyponatremia.

Role of Plasma Osmolality in AVP and Aldosterone Release in Korean Young Men (혈장 삼투질 농도 변동에 따른 항이뇨 호르몬과 Aldosterone 분비조절 : 한국청년)

  • Lee, Won-Jung;Choo, Young-Eun;Koo, Ja-Hoon
    • The Korean Journal of Physiology
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    • v.21 no.2
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    • pp.297-304
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    • 1987
  • A study was carried out to find out the relationship between arginine vasopressin (AVP) release and plasma osmolality in 15 young men (age: 21.4 yr). After an overnight fasting, wale. (20 ml/kg) was imbibed, and venous blood and urine samples were collected every 30 min for 90 min. then 5% saline was infused (0.06 ml/min/kg) for 120 min. AVP was extracted on Sep-Pak column and measured by radioimmunoassay. Under basal condition, plasma osmolality (pOsm), AVP (pAVP) and aldosterone (pAldo) levels were 286.5 mOsm/kg, 1.1 pg/ml, and 140 pg/ml, respectively. pAVP became undetectable during maximum water diuresis, and increased in response to hypertonic saline infusion. pAVP level began to increase when pOsm was above 280 mOsm/kg. Changes in urinary AVP excretion (uAVP) was parallel to pAVP levels. The fall in pAVP was followed by a decrease in uAVP, uOsm and an increase in free water clearance, while the later rise in pAVP was followed by an increase in uAVP, uOsm and a decrease in free water clearance. When pooling all data together, relationships between pAVP and pOsm, and uAVP and uOsm were best expressed by an exponential relationship (r=0.78, 0.86, respectively). pAldo level decreased to 71 pg/ml after water ingestion, and decreased further to 30 pg/ml 2 hr after 5% saline infusion. Even at the same pNa, pAldo level during dehydration state was significantly higher than during hydration state. Negative exponential relation (r=-0.59) was observed between pAldo and pNa. Response to change in body fluid volume was greater in aldosterone than in AVP release.

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Development of objective indicators for quantitative analysis of sodium intake: the sodium to potassium ratio of second-void urine is correlated with 24-hour urinary sodium excretion

  • Kim, Jung Gon;Han, Sang-Woong;Yi, Joo Hark;Park, Hyeong Cheon;Han, Sang Youb
    • Nutrition Research and Practice
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    • v.14 no.1
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    • pp.25-31
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    • 2020
  • BACKGROUND/OBJECTIVES: To date, sodium intake has been evaluated based on spot urine instead of 24-hour (hr) urine collection. Nevertheless, the optimal method for assessing daily sodium intake remains unclear. SUBJECTS/METHODS: Fifteen male (age 32.7 ± 6.5 years) participants were offered 3 meals with a total of 9-10 g salt over 24 hours, and 24-hr urine was collected from the second-void urine of the first day to the first-void urine of the second day. Twenty-four-hr urinary sodium (24UNa) was estimated using Tanaka's equation and the Korean formula, and spot urine Na, potassium (K), chloride (Cl), urea nitrogen (UN), creatinine (Cr), specific gravity (SG) and osmolality (Osm) were measured. The ratios of urinary Na to other parameters were calculated, and correlations with total measured 24UNa were identified. RESULTS: Average 24-hr urine volume was 1,403 ± 475 mL, and measured 24UNa was 143.9 ± 42.1 mEq (range, 87.1-239.4 mEq). Measured 24UNa was significantly correlated with urinary Na/UN (r = 0.560, P < 0.01), urinary Na/Osm (r = 0.510, P < 0.01), urinary Na/Cr (r = 0.392, P < 0.01), urinary Na/K (r = 0.290, P < 0.01), 24UNa estimated using Tanaka's equation (r = 0.452, P < 0.01) and the Korean formula (r = 0.414, P < 0.01), age (r = 0.548, P < 0.01), weight (r = 0.497, P < 0.01), and height (r = 0.393, P < 0.01) in all spot urine samples. Estimated 24UNa based on the second-void spot urine of the first day tended to be more closely correlated with measured 24UNa than were estimates from the other spot urine samples. The significant parameters correlated with the second-void urine of the first day were urinary Na/K (r = 0.647, P < 0.01), urinary Na/Cr (r = 0.558, P < 0.05), and estimated 24UNa using Tanaka's equation (r = 0.616, P < 0.05) and the Korean formula (r = 0.588, P < 0.05). CONCLUSIONS: Second-void urine is more reliable than first-void urine for estimating 24UNa. Urinary Na/K in the second-void urine on the first day is significantly correlated with 24UNa. Further studies are needed to establish the most reliable index and the optimal time of urine sampling for predicting 24UNa.

The Effect of Juglandis Semen Aquacupuncture on Urine Concentrating Defect in Glycerol-induced Acute Renal Failure (호도약침(胡桃藥鍼)이 Glycerol에 의한 급성신부전(急性腎不全) 유발(誘發)시 요농축능(尿濃縮能)의 장애(障碍)에 대한 영향(影響))

  • Lee, Byung-Hoon;Seo, Jung-Chul;Youn, Hyoun-Min;Song, Choon-Ho;Ahn, Chang-Beohm;Jang, Kyung-Jeon
    • Journal of Acupuncture Research
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    • v.18 no.3
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    • pp.114-122
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    • 2001
  • Objective : The present study was carried out to determine if Juglandis Semen Aquacupuncture(JSA) exerts beneficial effect against the urine concentrating defect induced by glycerol injection in rabbits. Methods : In order to test the effect of JSA, rabbits were acupunctured with $0.5m{\ell}$ of 1%JSA for 7days at both sides of $Sh{\grave{e}}ns{\bar{u}}$(BL23) before the glycerol injection. The other animals were pretreated with an equal volume of saline instead of JSA. Results : The urine flow was reduced, but the urine osmolality was significantly lower than the basal period in glycerol-injected animals, indicating that glycerol causes the urine concentrating defect. The fractional excretion of Na and K was increased in glycerol-treated animals. The Free-water clearance and fractional water excretion(V/GFR) were increased in animals treated with glycerol. Conclusion : These results indicate that glycerol injection resulted an impairment in the urine concentrating ability in rabbits. Such changes were prevented by JSA. JSA may be used as a method to treat and prevent glycerol-induced acute renal failure.

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Effects of Alcohol Intake on Body Fluid Balance and Fat Mobilization After Exercise Induced Dehydration

  • Park, Hyun-Jeong;Bae, Yoon-Jung;Lee, Joo-Hyung;Lee, Dae-Taek
    • Nutritional Sciences
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    • v.9 no.2
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    • pp.124-130
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    • 2006
  • To examine the effects of alcohol consumption on body fluid restoration and fat mobilization following exercise induced dehydration, nine healthy collegiate men ($24{\pm}2yrs,\;177{\pm}5cm,\;72{\pm}8kg,\;10.5{\pm}2.3%$ body fat) underwent three experiments. In each experiment, subjects ran on a treadmill to reduce individual body mass to $2.2{\pm}0.1%$ and consumed one of three beverages containing 0, 4, or 8% alcohol over 60 min followed by 4 hr of resting recovery. They consumed approximately 150% of weight loss $(2053{\pm}204,\;2091{\pm}149,\;and\;1943{\pm}295mL)$ and content of alcohol was $9.9{\pm}1.0(0%),\;71.9{\pm}5.1(4%)$, and $132.2{\pm}20.1g$ (8% trial). Body weight, urine volume and samples, blood samples, and thirst sensation were measured five times; at baseline, immediately after exercise, and 0, 1st, and 4th hr of recovery. Blood alcohol concentration after ingestion was $0.0{\pm}0.0(0%),\;0.1{\pm}0.02(4%)$, and $0.2{\pm}0.03%$ (8% trial). No differences in blood sodium and potassium concentrations, and urine specific gravity were noticed over time periods and trials. Thirst sensation tended to be elevated in all trials immediately after exercises and urine output was elevated during the recovery. The magnitude of changes in these variables was proportional to the alcohol concentrations, but not statistically significant. While serum osmolality was not different among trials and time periods in 0 and 4% trials, it was higher during recovery than the baseline in the 8% trial (P<0.01). Triglycerides did not change throughout the time period and among trials. Free fatty acids were elevated after exercise in all trials and 4th hr of recovery in 0% (P<0.05). Subjects' net body fluid balance at 4th hr of recovery was negatively maintained and proportional to alcohol concentrations. Only 8% trials showed a significant reduction at 1st and 4th hr of recovery compared to 0 hr. The results suggested that diuretic effect of alcohol after moderate level of dehydration appeared dose dependent, but beverage containing alcohol up to 4% did not induce impaired rehydration than alcohol free drinks. Alcohol effects on fat mobilization during recovery appeared to be minimal and the mechanism is unclear.

Studies on the Water and Na Metabolism of Roosters Fed Various Sources of Dietary Fiber (여러 가지 종류의 사료 섬유질을 섭취하는 수탉의 수분 및 Na대사에 관한 연구)

  • 이봉덕;이수기;정하연;임재삼
    • Korean Journal of Poultry Science
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    • v.12 no.2
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    • pp.97-105
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    • 1985
  • Fifteen 1-yr old roosters were employed in order to investigate the influence of various dietary fibers on the water and Na metabolism of chicken. Wheat bran, pure cellulose and ground rice straw replaced corn in the control diet at 10% level; Pectin replaced corn at 8% level. Three roosters were allotted per dietary treatment and one rooster per replicate. The limit of probability accepted as being significant was P$\leq$.05. The dry matter metabolizabilities of cellulose and rice straw diets were significantly lower, and those of control and pectin diets were significantly higher than that of the wheat bran diet. Pectin fed roosters seemed to drink more water than did the other birds. Also, excreta from roosters fed the pectin diet were significantly wetter than those from other treatments. However, no difference in water intake and fecal moisture were found when !he roosters were colostomized. It was also found that the colostomized birds drank more water than did intact ones. Data of water holding capacity and bulk density of dried excreta showed that cellulose, rice straw and wheat bran in decreasing order were strong in fibrous property. There were no significant differences in C$_{Na+}$ , Cosm and C$_{{H_2}O}$ among all treatments. When the values of urine volume, urine osmolality and C$_{{H_2}O}$ were put together, it can be concluded that 11 out of 15 roosters developed diuresis. More severe diuretic symptoms were developed in roosters when they were fed more fibrous diets. In conclusion, when the four dietary fibers were graded in terms of fibrous property, it turned out to be pectin, cellulose, rice straw and wheat bran in decreasing order.

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EFFECTS OF HEAT EXPOSURE ON WATER METABOLISM AND PASSAGE IN SHEEP

  • Katoh, K.;Buranakarl, C.;Matsunaga, N.;Lee, S.R.;Sugawara, T.;Sasaki, Y.
    • Asian-Australasian Journal of Animal Sciences
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    • v.2 no.2
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    • pp.91-97
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    • 1989
  • The present experiment was carried out to investigate the effects of heat exposure on water metabolism and the passage of indigestible particles in sheep. Water intake, respiratory rate, rectal temperature and pH of ruminal fluid and urine were significantly higher (P<0.05) in the hot environment ($32\;^{\circ}C$) than in the control environment ($20\;^{\circ}C$). Urine osmolality and blood volume were increased, while glomerular filtration rate was decreased, in the hot environment. The liquid flow rate from reticulo-rumen and the excretion of indigestible particles of specific gravity 0.99 (but not 1.27 or 1.38) were increased in the hot environment. From these findings, it is suggested that an increased water intake evoked by heat exposure might affect the flow rate of digesta in sheep.

Decreased Expression of $Na^+/K^+$-ATPase, NHE3, NBC1, AQP1 and OAT in Gentamicin-induced Nephropathy

  • Bae, Woo-Kyun;Lee, Jong-Un;Park, Jeong-Woo;Bae, Eun-Hui;Ma, Seong-Kwon;Kim, Suhn-Hee;Kim, Soo-Wan
    • The Korean Journal of Physiology and Pharmacology
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    • v.12 no.6
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    • pp.331-336
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    • 2008
  • The present study was aimed to determine whether there is an altered regulation of tubular transporters in gentamicin-induced nephropathy. Sprague-Dawley male rats ($200{\sim}250\;g$) were subcutaneously injected with gentamicin (100 mg/kg per day) for 7 days, and the expression of tubular transporters was determined by immunoblotting and immunohistochemistry. The mRNA and protein expression of OAT was also determined. Gentamicin-treated rats exhibited significantly decreased creatinine clearance along with increased plasma creatinine levels. Accordingly, the fractional excretion of sodium increased. Urine volume was increased, while urine osmolality and free water reabsorption were decreased. Immunoblotting and immunohistochemistry revealed decreased expression of $Na^+/K^+$-ATPase, NHE3, NBC1, and AQP1 in the kidney of gentamicin-treated rats. The expression of OAT1 and OAT3 was also decreased. Gentamicin-induced nephropathy may at least in part be causally related with a decreased expression of $Na^+/K^+$-ATPase, NHE3, NBC1, AQP1 and OAT.

Urinary Calcium Excretion in Children with Primary Monosymptomatic Nocturnal Enuresis (일차성 단일증상성 야뇨증 환아에서 소변내로의 요칼슘배설에 대한 연구)

  • Chung, Woo-Yeong;Cho, Min-Hyun;Park, Yong-Hoon
    • Childhood Kidney Diseases
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    • v.15 no.2
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    • pp.146-153
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    • 2011
  • Purpose : Hypercalciuria has been suggested to be involved in the pathogenesis of nocturnal enuresis associated with polyuria. We have measured the amount of calcium excretion in the urine from children with monosymptomatic nocturnal enuresis and studied the association with enuresis. Methods : Thirty-six children (20 males and 16 females, age 5 to 15.6 years) presenting with monosymptomatic nocturnal enuresis were recruited for this study. Results : Among 36 patients, 6 patients had hypercalciuria, providing a 16.7% frequency. The mean Ca/Cr ratio of hypercalciuria group showed $0.23{\pm}0.10$ on daytime, and $0.33{\pm}0.10$ on nighttime showing higher values in nighttime, but it was not statistically significant. Average 24 hour calcium excretion was 8.95 mg/kg. Night/day time urine volume ratio in hypercalciuria group was $0.87{\pm}0.20$, and that in normocalciuria group was $0.81{\pm}0.33$, also showing no difference. Daytime Ca/Cr ratio and nighttime Ca/Cr ratio from all enuresis patients showed a significant correlation (P=0.0001). However, Ca/Cr ratio between daytime and nighttime urine volume had no significant correlation, respectively (daytime P=0.08; nighttime P=0.07). Also, daytime and nighttime Na concentration, urea concentration, and osmolality also had no significant correlation with urine Ca/Cr ratio, respectively. Conclusion: Hypercalciuria shown in some of enuresis patients is not directly caused by primary monosymptomatic nocturnal enuresis.