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The applicability of the urine color scale in pediatric urology
Eduarda Alvarez Silva1, Matheus Mascarenhas Portugal1, Noel Charlles Nunes1
1Center of Urinary Disorders in Children (CEDIMI), Bahiana School of Medicine and Public Health (EBMSP), Salvador, Bahia, Brazil.
Insights
The urine color scale (UCS) shows good agreement between healthcare professionals and parents for assessing pediatric hydration status in urinary dysfunction. While patient agreement varied, the UCS remains a valuable tool for evaluating hydration.
Area of Science:
- Pediatric Urology
- Diagnostic Tools
- Hydration Assessment
Background:
- Urinary dysfunction in children can impact hydration status.
- Accurate hydration assessment is crucial for effective management.
- The urine color scale (UCS) is a potential tool for evaluating hydration.
Purpose of the Study:
- To assess agreement in urine color scale interpretation among healthcare professionals, patients, and parents.
- To evaluate the applicability of the UCS as a diagnostic tool for hydration status in pediatric urinary dysfunction.
- To analyze inter-rater reliability for the UCS in a pediatric urology setting.
Main Methods:
- Cross-sectional study of 44 patients aged 5-17 with lower urinary tract symptoms and enuresis.
- Conducted at a public pediatric urology referral center in Bahia, Brazil.
- Agreement assessed using kappa and weighted kappa coefficients, with statistical analysis via SPSS.
Main Results:
- Weighted kappa showed substantial agreement between healthcare professionals and parents/guardians (82.4%) and professionals and patients (70.6%).
- Agreement between patients and parents/guardians was moderate (51.5%).
- Kappa values indicated fair to moderate agreement across all groups, with significant differences when professionals were compared to others.
Conclusions:
- The urine color scale (UCS) demonstrates utility in assessing pediatric hydration status, particularly with professional-parental agreement.
- Despite some interpretation inconsistencies, the UCS is a valuable diagnostic aid.
- Further research may refine UCS application in pediatric urology for improved hydration monitoring.
Aims:
To determine the level of agreement between healthcare professionals, patients and their parents/guardians in the interpretation of the urine color scale (UCS) in cases of urinary dysfunction, analyzing the applicability of the scale as a diagnostic tool determining the hydration status.
Methods:
This was a cross-sectional study involving 5-17-year-old patients with lower urinary tract symptoms (LUTS) and enuresis. The study was conducted in a public healthcare referral center for pediatric urology in the Brazilian state of Bahia between October 2019 and March 2020. The Kolmogorov-Smirnov test was used to assess the distribution of the variables. Agreement was assessed using the kappa coefficient and weighted kappa. The z-test was used to determine significant differences between the kappa and weighted kappa. The statistical analysis was conducted using SPSS, version 14, and significance was established at p < 0.05.
Results:
Forty-four patients were included. The kappa value was 32.4% (p = 0.000) for the agreement between healthcare professionals and patients, 41.9% (p = 0.000) for agreement between healthcare professionals and parents/guardians, and 25.0% (p = 0.001) for agreement between patients and parents/guardians. The weighted kappa was 70.6% (p = 0.000) for agreement between healthcare professionals and patients, 82.4% (p = 0.000) for agreement between healthcare professionals and parents/guardians, and 51.5% (p = 0.001) for agreement between patients and parents/guardians. There was a statistically significant difference in kappa values when the healthcare professionals were compared with the other groups.
Conclusions:
Although there were some inconsistencies in interpretation, the UCS proved to be a useful tool with which to evaluate patients' hydration status.
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