24-h Void number as an indicator of hydration status

Few user-friendly hydration assessment techniques exist for the general population to use on a daily basis. The present study evaluated void number over 24 h as a potential hydration assessment tool.

Male and female subjects collected urine for 24 h while adequately hydrated (n=44; 22 ± 4 years, 168 ± 16 cm, 73 ± 15 kg) or fluid restricted (n=43; 22 ± 3 years, 175 ± 10 cm, 81 ± 24 kg). As a control, participants were asked to void when feeling the 'first urge to void' on a commonly used urge scale and noted the volume of each void. For each sample, 24-h urine volume, osmolality (U(OSM)), specific gravity (U(SG)) and color were measured in the laboratory.

As designed, the level of urge upon voiding was consistent throughout the study (2 ± 0; 'first urge to void'). Samples were classified by U(SG) as either euhydrated (U(SG)<1.020) or hypohydrated (U(SG) ⩾ 1.020). Grouping by U(OSM) did not change results. Euhydrated versus hypohydrated individuals had greater 24-h urine volume (1933 ± 864 versus 967 ± 306 ml, respectively) and lower urine color (2 ± 1 versus 5 ± 1), U(SG) (1.012 ± 0.004 versus 1.025 ± 0.004) and UOSM (457 ± 180 versus 874 ± 175 mOsm/kg H2O; all P<0.001). Euhydrated individuals voided more than hypohydrated individuals over the 24-h period (5 ± 2 versus 3 ± 1 voids; P<0.001). Additionally, void number inversely correlated with hydration status as identified by U(SG) (r=-0.50; P<0.05) and U(OSM) (r=-0.56; P<0.05).

In conclusion, over 24 h, individuals with a higher void number were euhydrated (that is, had less concentrated hydration biomarkers) than those with a lower void number. Based on these data, void number might be utilized as a simple and feasible hydration assessment for the general public, as it utilizes no equipment or technical expertise.