Predicting urinary creatinine excretion and its usefulness to identify incomplete 24 h urine collections

Br J Nutr. 2012 Sep 28;108(6):1118-25. doi: 10.1017/S0007114511006295. Epub 2011 Dec 5.

Abstract

Studies using 24 h urine collections need to incorporate ways to validate the completeness of the urine samples. Models to predict urinary creatinine excretion (UCE) have been developed for this purpose; however, information on their usefulness to identify incomplete urine collections is limited. We aimed to develop a model for predicting UCE and to assess the performance of a creatinine index using para-aminobenzoic acid (PABA) as a reference. Data were taken from the European Food Consumption Validation study comprising two non-consecutive 24 h urine collections from 600 subjects in five European countries. Data from one collection were used to build a multiple linear regression model to predict UCE, and data from the other collection were used for performance testing of a creatinine index-based strategy to identify incomplete collections. Multiple linear regression (n 458) of UCE showed a significant positive association for body weight (β = 0·07), the interaction term sex × weight (β = 0·09, reference women) and protein intake (β = 0·02). A significant negative association was found for age (β = -0·09) and sex (β = -3·14, reference women). An index of observed-to-predicted creatinine resulted in a sensitivity to identify incomplete collections of 0·06 (95 % CI 0·01, 0·20) and 0·11 (95 % CI 0·03, 0·22) in men and women, respectively. Specificity was 0·97 (95 % CI 0·97, 0·98) in men and 0·98 (95 % CI 0·98, 0·99) in women. The present study shows that UCE can be predicted from weight, age and sex. However, the results revealed that a creatinine index based on these predictions is not sufficiently sensitive to exclude incomplete 24 h urine collections.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Age Factors
  • Aged
  • Biomarkers / urine
  • Body Weight
  • Creatinine / urine*
  • Diet / ethnology
  • Europe
  • Female
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Patient Compliance* / ethnology
  • Sex Characteristics
  • Urine Specimen Collection*

Substances

  • Biomarkers
  • Creatinine