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Front. Pediatr. | doi: 10.3389/fped.2018.00160

Mobile Technology Application for Improved Urine Concentration Measurement Pilot Study

 Laura Walawender1, Jeremy Patterson2, Robert Strouse2, John Ketz3,  Vijay Saxena4,  Emily Alexy5 and  Andrew L. Schwaderer4*
  • 1Pediatric Residency, Nationwide Children's Hospital, United States
  • 2User Experience Technology Research and Development, Nationwide Children's Hospital, United States
  • 3Center for Clinical and Translational Medicine, Nationwide Children's Hospital, United States
  • 4Pediatric Nephrology, Riley Hospital for Children, United States
  • 5Biostatistics Core, Nationwide Children's Hospital, United States

Objectives: Low hydration has a deleterious effect on many conditions. In the absence of a urine concentrating defect, urine concentration is a marker of hydration status. However, markers to evaluate hydration status have not been well studied in children. The objectives of this paper are to compare measures of thirst and urine concentration in children and to develop a novel mobile technology application to measure urine concentration.
Study Design: Children age 12-17 years were selected (n=21) for this pilot study. Thirst perception, specific gravity (automated dipstick analysis and refractometer), and urine color scale results were correlated to urine osmolality. The technology department developed a mobile technology camera application to measure light penetrance into urine which was tested on 25 random anonymized urine samples.
Results: The patient’s thirst perception and color scale as well as two researchers color scale did not significantly correlate with osmolality. Correlation between osmolality and hydration markers resulted in the following Pearson coefficients: SG automated dipstick, 0.61 (P 0.003); SG refractometer, 0.98 (P < 0.0001); urine color scale (patient), 0.37 (P 0.10), and light penetrance, -0.77 (P < 0.0001). The correlation of light penetrance with osmolality was stronger than all measures except SG by refractometer and osmolality.
Conclusion: The mobile technology application may be a more accurate tool for urine concentration measurement than specific gravity by automated dipstick, subjective thirst, and urine color scale, but lags behind specific gravity measured by refractometer. The mobile technology application is a step towards patient oriented hydration strategies.

Keywords: Thirst, Cell phone apps, hydration, Specific Gravity, urine colors

Received: 12 Apr 2018; Accepted: 15 May 2018.

Edited by:

Ana Cristina Simões E Silva, Universidade Federal de Minas Gerais, Brazil

Reviewed by:

Vera H. Koch, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
R. Morrison Hurley, Department of Medicine, University of British Columbia, Canada
Vimal Master Sankar Raj, University of Illinois at Chicago, United States  

Copyright: © 2018 Walawender, Patterson, Strouse, Ketz, Saxena, Alexy and Schwaderer. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Andrew L. Schwaderer, Riley Hospital for Children, Pediatric Nephrology, Indianapolis, United States,