Reliability of Reagent Strips for Semi-quantitative Measurement of Glucosuria in a Neonatal Intensive Care Setting

Jolita Bekhof*, Boudewijn J. Kollen, Sjef van de Leur, Joke H. Kok, Irma H. L. M. van Straaten

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)
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Abstract

Background: Glucosuria in preterm infants is often measured using a visually readable reagent strip, e.g., when monitoring total parenteral nutrition or during sepsis or when treating with corticosteroids. However, the specific circumstances in a neonatal intensive care unit (NICU), such as the use of diapers and the high temperature in incubators, could affect its reliability. Objectives: To evaluate the reliability of the semi-quantitative measurement of glucosuria under the specific circumstances of a NICU setting.

Methods: Nine hundred assessments of artificially supplemented (contrived) urine samples, intended to simulate pathological specimens, were performed under the following varying conditions: environmental temperature (21 degrees C and 34 degrees C); different times of contact of the urine with the diaper; and using two different methods of collecting urine from the diaper. Each reagent strip was read independently by three observers. The test strips scores were categorized as 0, 1+, 2+, 3+, or 4+ in ascending degree of glucosuria.

Results: Agreement was excellent under all the different conditions (temperature, weighted kappa (kappa(w)) = 0.92; method of urine collection, kappa(w) = 0.88; time, p = 0.266). Inter-observer reliability was very good (multi-rater kappa = 0.81). The deviation between the different conditions was seldom larger than one category (2.94 The reagent strip readings were concordant with the true urinary glucose concentrations in 79.0% of assessments. The discordance was never larger than one category.

Conclusion: The reliability of the semi-quantitative measurement of glucosuria in newborn infants using reagent strips is good, even under the conditions of a NICU. Changes in the rating of reagent strips of more than one category are most likely to be beyond measurement error.

Original languageEnglish
Pages (from-to)444-448
Number of pages5
JournalPediatrics and Neonatology
Volume55
Issue number6
DOIs
Publication statusPublished - Dec-2014

Keywords

  • agreement
  • dipsticks
  • glucosticks
  • precision
  • reproducibility
  • urine
  • validity
  • PRETERM
  • HYPERGLYCEMIA
  • NEWBORN
  • INFANTS

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