Abstract
Maintaining one’s hydration status is recommended by the American College of Sports Medicine and is critical for optimal cellular function and performance. Simple, inexpensive, and accurate hydration assessment techniques such as urine test strips have been widely utilized to confirm urinary hydration indices however their validity is yet to be examined. PURPOSE: To determine the validity of Siemens® Multistix 10G urine strip in the assessment hydration status via urine specific gravity (USG). METHODS: 427 fresh urines samples form health athletic and non-athletic population were analyzed for urine specific gravity with a refractometer (RF; ATAGO-Master) and urine strip (US; Siemens Multistix 10G). The data were analyzed using pearson-product moment correlation to assess the relationship between RF and US. Bland-Altman analysis to assess potential bias, and receiver operating characteristic (ROC) analysis to establish the diagnostic ability of the urine strips to detect hypohydration. RESULTS: Mean USG by RF (1.019±0.008) was significantly correlated (r=0.33; p<0.0001) with US (1.019±0.009). Bland-Altman analysis demonstrated that 81.6% of the samples were within 95% confidence interval, however there was a bias indicating that at higher USG values were linked to greater disparity between the two methods (R2= 0.016, p= 0.008). ROC analysis indicated that US had fair overall classification ability for hypohydration (area under the curve 77.5%). However the sensitivity to correctly identify hypohydration was poor (62%) and the specificity of correctly identifying euhydration was inadequate (45%). Cut-off point analysis indicated the optimal cut-off point of hypohydration based on the urine strips was 1.025. CONCLUSION: The data indicated that the urine strip method is not valid for hydration assessment compared to refractometry. Until a convenient and inexpensive method for assesing urine specific gravity is developed, hand held refractometry is reccommended over urine strips.
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