pH ölçümlerinin karşılaştırmalı analizi: İdrar dipstik ve pH metre

Öz

Amaç: İdrar pH'ı, bir bireyin metabolik ve fizyolojik durumunu değerlendirmede kritik bir parametredir. Bu çalışmanın amacı, idrar pH'ının dipstik ölçümünü altın standart yöntem olan pH metre ile karşılaştırmaktır. Gereç ve Yöntemler: Her numune, kombine cam elektrotlu Jenway 3310 pH metre ile ve ardından Sysmex UC-3500 idrar analizörü ile Meditape UC-9A idrar dipstikleri kullanılarak hemen test edildi. Bulgular: Zonguldak Bülent Ecevit Üniversitesi Hastanesi'nde yatan ve ayaktan hastalardan toplam 3043 idrar örneği toplandı. İdrar dipstikleri ile pH metre arasında güçlü bir korelasyon bulundu, rho değeri 0,909 (95% CI 0,902 ila 0,915), p<0,001. Yöntemler arasındaki sapma değerleri -0,18 (95% CI -0,1893 ila -0,1695) idi, iki standart sapma alt sınırı -0,72 (95% CI -0,74 ila -0,70) ve üst sınırı 0,36 (95% CI 0,34 ila 0,38) olarak belirledi. Sonuç: İdrar dipstikleri, rutin kontroller ve ilk taramalar için kolaylık ve pratiklik sunar. Buna karşılık, pH ölçerler kapsamlı klinik değerlendirmeler ve araştırma uygulamaları için çok önemli olan hassasiyet ve güvenilirlik sunar. Bu nedenle, doğru ölçüm gerektiğinde cam elektrotlu bir pH ölçer zorunludur.

Anahtar Kelimeler

• İdrar pH
• idrar dipstik
• pH metre

Comparative analysis of pH measurements: Urine dipstick and pH meter

Öz

Aim: Urine pH is a critical parameter in assessing an individual’s metabolic and physiological status. The aim of this study was to compare dipstick measurement of urinary pH with gold standard pH meter readings. Material and Methods: Each sample was tested by Jenway 3310 pH meter with a combined glass electrode and again using Meditape UC‐9A urine dipsticks with Sysmex UC-3500 dipstick analyzer. Results: A total of 3043 urine specimens were collected immediately after voiding from in-patients and out-patients at the Zonguldak Bulent Ecevit University Hospital. A strong correlation was found between urine dipstick and pH meter, with a rho value of 0.909 (95% CI 0,902 to 0.915), p<0.001. The bias values were between techniques was -0.18 (95% CI -0.1893 to -0.1695) with the two standard deviations establisheing the lower limit at −0.72 (95% CI -0.74 to -0.70) and the upper limit at 0.36 (95% CI 0.34 to 0.38), respectively. Conclusion: Urine dipsticks offer expediency and practicality, making them suitable for routine checks and initial screenings. Conversely, pH meters deliver precision and reliability that is pivotal for comprehensive clinical assessments and research applications. Therefore, a pH meter with a glass electrode is mandatory when accurate measurement is necessary.

Anahtar Kelimeler

• Urine pH
• urine dipstick
• pH meter

Kaynakça

1. Eknoyan G. Looking at the urine: the renaissance of an unbroken tradition. Am J Kidney Dis. 2007;49(6):865-872. https://doi.org/10.1053/j.ajkd.2007.04.003
2. Welch AA, Mulligan A, Bingham SA, Khaw KT. Urine pH is an indicator of dietary acid-base load, fruit and vegetables and meat intakes: results from the European Prospective Investigation into Cancer and Nutrition (EPIC)-Norfolk population study. Br J Nutr. 2008;99(6):1335-1343. https://doi.org/10.1017/S0007114507862350
3. Lai HC, Chang SN, Lin HC, Hsu YL, Wei HM, Kuo C, et al. Association between urine pH and common uropathogens in children with urinary tract infections. J Microbiol Immunol Infect. 2021;54(2):290-298. https://doi.org/10.1016/j.jmii.2019.08.016
4. Ogawa S, Nako K, Okamura M, Ito S. Lower urinary pH is useful for predicting renovascular disorder onset in patients with diabetes. BMJ Open Diabetes Res Care. 2015;3(1):e000097. https://doi.org/10.1136/bmjdrc-2015-000097
5. Mittal K, Aggarwal HK, Rungta N, Patki V. Respiratory acidosis and alkalosis. J Pediatr Crit Care. 2021;8(3):161-164. https://doi.org/10.21304/2021.0803.007
6. Wang Z, Zhang Y, Zhang J, Deng Q, Liang H. Recent advances on the mechanisms of kidney stone formation. Int J Mol Med. 2021;48(2):149. https://doi.org/10.3892/ijmm.2021.4962
7. Galan-Llopis JA, Torrecilla-Ortiz C, Luque-Gálvez MP, Peris-Nieto X, Cuñé-Castellana J. Urinary pH as a target in the management of lithiasic patients in real-world practice: monitoring and nutraceutical intervention for a nonlithogenic pH range. Clin Med Insights Urol. 2019;12:1179561119877343. https://doi.org/10.1177/1179561119877343
8. Ordaz G, Dagà U, Budia A, Pérez-Lanzac A, Fernández JM, Jordán C. Urinary pH and antibiotics, choose carefully: a systematic review. Actas Urol Esp. 2023;47(7):408-415. https://doi.org/10.1016/j.acuro.2023.02.003

9. Desai RA, Assimos DG. Accuracy of urinary dipstick testing for pH manipulation therapy. J Endourol. 2008;22(6):1367-1370. https://doi.org/10.1089/end.2008.0063
10. Johnson KY, Lulich JP, Osborne CA. Evaluation of the reproducibility and accuracy of pH-determining devices used to measure urine pH in dogs. J Am Vet Med Assoc. 2007;230(3):364-369. https://doi.org/10.2460/javma.230.3.364
11. Mina A, Stathopoulos J, Sinanian T, McNeice L, Holmes D, Fletcher KL, et al. Comparison of different methods used in drugs of abuse for sample validity testing including pH methods, specific gravity methods, TECO™ drug adulteration test strip and oxidant assay. Adv Lab Med. 2021;2(4):550-557. https://doi.org/10.1515/almed-2021-0035
12. Coninck V, Keller EX, Monsalve MR, Doizi S, Audouin M, Haymann JP, et al. Evaluation of a portable urinary pH meter and reagent strips. J Endourol. 2018;32(7):647-652. https://doi.org/10.1089/end.2017.0855
13. Ilyas R, Chow K, Young JG. What is the best method to evaluate urine pH? A trial of three urinary pH measurement methods in a stone clinic. J Endourol. 2015;29(1):70-74. https://doi.org/10.1089/end.2014.0408
14. Wockenfus AM, Koch CD, Conlon P, Sorensen L, Cambern K, Chihak A, et al. Discordance between urine pH measured by dipstick and pH meter: implications for methotrexate administration protocols. Clin Biochem. 2013;46(1-2):152-154. https://doi.org/10.1016/j.clinbiochem.2012.10.009
15. Kwong T, Robinson C, Spencer D, Wiseman OJ, Frankl F. Accuracy of urine pH testing in a regional metabolic renal clinic: is the dipstick accurate enough? Urolithiasis. 2013;41(2):129-132. https://doi.org/10.1007/s00240-012-0526-3