Application And Significance Of Random Urine Na~+/K~+ Ratio Test In Clinical Treatment Of Patients With Cirrhosis And Ascites

Objective:The treatment of cirrhosis with ascites usually limits the intake of salt and the use of diuretics,24h urinary sodium displacement is greater than 78mmol/L,the diuretic was considered effective.However,the detection of 24h urinary sodium excretion is not convenient,so we use a diuretic in the morning to observe patients in the morning and afternoon,random urine Na~+/K~+ ratio can correctly reflect the 24h urinary sodium excretion and urinary Na~+/K~+ ratio distribution.The above treatment was used to evaluate the ratio of Na~+/K~+ of random urine.Methods:Choose 42 patients with cirrhosis and ascites in our hospital fro m January 2014 to-October 2015.At 8:00(AM)each patient was given diuret ics,24h urine volume was collected,5ml urine was collected randomly after using diuretics 2-4h and 10-12h,and 24h urinary sodium excretion,random urine Na~+/K~+ ratio and ROC curve were used to analyze the random urine Na~+/K~+ratio.Results:42 patients were selected 40 patients for analysis with urinary creatinine greater than 15 mEq/Kg,the mean urinary output of 24h was 1722.5± 915.3 ml(500-3500 ml)and the mean value of 24h urinary sodium excretion was about 107.9 ± 91.2 mmol/L(3-366 mmol/L),the morning and in the a fternoon the urinary Na~+/K~+ ratio respectively was 3.44 ±3.64 and 3.97 ±4.60,The urinary excretion of 24h was more than 78 mmol/L.Patients in the morning and afternoon random urine Na~+/K~+ ratio using ROC curve analysis.In the morning,the area under the ROC curve of random urine Na~+/K~+ ratio was 0.861,and in the afternoon the area under the ROC curve of random urine Na~+/K~+ ratio was 0.929.Analysis of the Na~+/K~+ ratio consistency in the morning and afternoon by the area under the ROC curve,the area of morning random urine Na~+/K~+ ratio under the ROC curve and the afternoon random urine Na~+/K~+ ratio of the area under the ROC curve is the difference of 0.0682(95%CI,-0.161-0.153,P=0.113),no statistically significant difference,when the Na~+/K~+ ratio was above 1.25,the urinary excretion of 24h was more than 78 mmol/L.Conclusions:When the urinary Na~+/K~+ ratio was more than 1.25,the urinary sodium excretion of 24h was more than 78 mmol/L.The random urine Na~+/K~+ ratio is a convenient,sensitive and specific index to judge the diuretic effect.