Background To reduce the risk of renal toxicity, urine specific gravity (SG) and pH (potential of hydrogen) parameters should be met before nephrotoxic chemotherapeutic agents are administered. The purpose of this study was to compare laboratory urine SG and pH values with those obtained with urine point-of-care (POC) testing methods commonly used when caring for children receiving nephrotoxic chemotherapeutic agents. Method A method-comparison design was used to compare the values of three POC methods for SG (dipstick, automated dipstick reader, refractometer) and three pH (dipstick, automated dipstick reader, litmus paper) methods with laboratory analysis of 86 urine samples from 43 children hospitalized on a pediatric hematology oncology unit in a large academic medical center. The Bland–Altman method was used to calculate bias and precision between POC and laboratory values. Results Except for the SG refractometer, bias values from Bland–Altman graphs demonstrated poor agreement between POC and laboratory urine SG and pH results. The precision values between these methods indicated overestimation or underestimation of hydration or urine pH status. Compared with laboratory methods, 31% of POC visual reading of dipstick SG values were falsely low—putting the patient at risk of not receiving necessary hydration and subsequent nephrotoxicity. Discussion In conclusion, most POC urine testing methods for SG and pH are not accurate compared with laboratory analysis. Because laboratory analyses can take longer than POC methods to obtain results, clinicians need to collaborate with laboratory medicine to ensure that an expedited process is in place in order to prevent chemotherapy administration delays.

中文翻译：

---

用于评估接受化疗的儿童的尿液比重和 pH 值的床旁检测方法和实验室分析的比较

背景 为降低肾毒性风险，应在使用肾毒性化疗药物前满足尿比重 (SG) 和 pH（氢势）参数。本研究的目的是将实验室尿液 SG 和 pH 值与在护理接受肾毒性化疗药物的儿童时常用的尿液即时 (POC) 检测方法获得的值进行比较。方法 方法比较设计用于比较三种 POC 方法的 SG（试纸、自动试纸读取器、折光仪）和三种 pH（试纸、自动试纸读取器、石蕊试纸）方法与来自 43 个国家的 86 个尿液样本的实验室分析值儿童在一家大型学术医疗中心的儿科血液肿瘤科住院。Bland-Altman 方法用于计算 POC 和实验室值之间的偏差和精密度。结果 除了 SG 折光仪，Bland-Altman 图中的偏差值表明 POC 与实验室尿液 SG 和 pH 结果之间的一致性较差。这些方法之间的精度值表明对水合作用或尿液 pH 状态的高估或低估。与实验室方法相比，31% 的试纸 SG 值的 POC 视觉读数错误地低 - 使患者面临无法接受必要的水合作用和随后的肾毒性的风险。讨论 总之，与实验室分析相比，大多数用于 SG 和 pH 值的 POC 尿液检测方法并不准确。因为实验室分析可能需要比 POC 方法更长的时间才能获得结果，