Use of a urine color chart to monitor hydration status in nursing home residents

To determine whether urine color, as measured by a color chart, might be a valid indicator of hydration status in frail nursing home residents, this study tested the associations between urine color and urine specific gravity This is a descriptive correlational study set in seven nursing homes in eastern Iowa. Ninety-eight nursing home residents ! 65 years of age participated. Exclusion criteria for the study included: unstable congestive heart failure or diabetes, documented renal disease, hyponatremia (serum sodium < 135 meq/L), terminal illness, acutely confused/delirious or urinary tract infection at baseline, and gastrostomy-tube dependence. Weekly urine specimens were collected. Ucol was measured first, using a urine color chart. Usg was determined using the Chemstrip Mini UA Urine Analyzer. Week-by-week Spearman rank order correlations between urine color and specific gravity for the total sample (n = 98) ranged from r(s) = 0.3 - 0.7, p <.01; the PROC mixed model was significant, p <.01. In subgroup analyses (n = 78), all females (r(s) = 0.67, p =. 01) and both males (r(s) = 0.53, p =. 01) and females (r(s) = 0.72, p =. 01) with adequate renal function (Cockcroft-Gault estimated creatinine clearance [CrCl] values of >= 50 ml/min) had significant associations between average urine color and average Usg. Females with mild renal impairment (CrCl between 30 and 50 ml/min) also had significant associations between Ucol and Usg (r(s) =.64, p <.01). Ucol averaged over several individual readings offers another tool in assessing hydration status in Caucasian nursing home residents with adequate renal function measures by estimated CrCl values.