Could Urine pH be a New Parameter for Mortality?
Main Article Content
Keywords
Intensive care unit, mortality, urinary pH
Abstract
Background: Full urine analysis is a simple and in expensive test that can be easily performed in almost all laboratories and provides extremely useful information. This study aimed to examine whether urinary pH has any prognostic role in respect of mortality in intensive care unit (ICU) patients. Methods: In this study, a retrospective examination of patients hospitalized in the Internal Diseases Intensive Care Unit between 2017-2018 at the Investigators' Hospital was performed. A total of 2100 patients were excluded, of which 563 met at least one of the exclusion criteria. Results: Age, the total length of hospital stay (TLSH), and mortality were significantly higher in the pH ≤ 5.5 group (p<0.001). In the multivariate logistic regression analysis, the age (p < 0001, OR = 0.978), TLSH (p < 0001, OR = 0.932), and urinary pH (p < 0.05, OR = 0.718) levels were determined as independent risk factors associated with mortality. Conclusion: The pH value in general ICU patients was evaluated in respect of mortality could be an independent risk factor for morbidity and mortality.
References
1. Brumfitt W, Hamilton-Miller JM, Cooper J, Raeburn A. Relationship of urinary pH to symptoms of 'cystitis'. Postgrad Med J. 1990:66;779:727-9.
2. Cho YH, Lee SY, Jeong DW, Choi EJ, Nam KJ, Kim YJ et al. The association between a low urine pH and the components of metabolic syndrome in the Korean population: Findings based on the 2010 Korea National health and nutrition examination survey. J Res Med Sci. 2014;19:599-604.
3. Kanbara A, Miura Y, Hyogo H, Chayama K, Seyama I. Effect of urine pH changed by dietary intervention on uric acid clearance mechanism of pH-dependent excretion of urinary uric acid. Nutr J. 2012:7;11:39.
4. D. Wright Wilson, W. L. Long, H. C. Thompson, Sylva Thurlow . Changes in the composition of the urine after muscular exercise. Biol Chem 1925;65:755-771.
5. Worcester EM, Bergsland KJ, Gillen DL, Coe FL. Mechanism for higher urine pH in normal women compared with men. Am J Physiol Renal Physiol. 2018:1;314:623-629.
6. Anderson RJ, Pluss RG, Pluss WT, Bell J, Zerbe GG. Effect of hypoxia and hypercapnic acidosis on renal autoregulation in the dog: role of renal nerves.Clin Sci. 1983;65:533-8.
7. Kobayashi H, Yoshiyama M, Zakoji H, Takeda M, Araki I. Sex differences in the expression profile of acid-sensing ion channels in the mouse urinary bladder: a possible involvement in irritative bladder symptoms. BJU Int. 2009;104:1746-51.
8. Seldin and Giebisch’s The Kidney (Physiology&Pathophysiology 1-2 Book.5 th Edition.2013
9. Worcester EM, Bergsland KJ, Gillen DL, Coe FL. Mechanism for higher urine pH in normal women compared with men. Am J Physiol Renal Physiol. 2018 ;314:623-629.
10. Sánchez-Freire V, Blanchard MG, Burkhard FC, Kessler TM, Kellenberger S,Monastyrskaya K. Acid-sensing channels in human bladder: expression, function and alterations during bladder pain syndrome. J Urol. 2011;186:1509-16.
11. Sönmez MG, Göğer YE, Ecer G, Atıcı A, Özkent MS, Öztürk A. Effects of urine alkalinization with sodium bicarbonate orally on lower urinary tract symptoms in female patients: a pilot study. Int Urogynecol J. 2018;29:1029-1033.
12. Shimodaira M, Okaniwa S, Nakayama T. Fasting Single-Spot Urine pH Is Associated with Metabolic Syndrome in the Japanese Population. Med Princ Pract.2017;26:433-437.
13. Hara S, Tsuji H, Ohmoto Y, Amakawa K, Hsieh SD, Arase Y, Nakajima H. High serum uric acid level and low urine pH as predictors of metabolic syndrome: a retrospective cohort study in a Japanese urban population. Metabolism. 2012;612:281-8.
14. Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY: Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004;351:1296–1305.
15. Nakanishi N, Fukui M, Tanaka M, Toda H, Imai S, Yamazaki M et al. Low urine pH Is a predictor of chronic kidney disease. Kidney Blood Press Res. 2012;35:77-81.
16. Ogawa S, Nako K, Okamura M, et al. Lower urinary pH is useful for predicting renovascular disorder onset in patients with diabetes BMJ Open Diabetes Research and Care 2015;3:e000097.