• Assessment
    What is the best clinical and/or biochemical parameter for hydration status in the adult (19-64 years)?
    • Conclusion

      In young, healthy and/or active adults urine specific gravity (Usg), urine osmolality (Uosm), serum osmolality (Sosm), and urine color (Ucol) are good indicators of hydration status. Additionally, body weight loss greater than 3% is a good indicator of acute dehydration.

      No single parameter is best in all adult populations.  

       

    • Grade: II
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.
    What is the best clinical and/or biochemical parameter for assessing hydration status in the older adult (>65 years) patient?
    • Conclusion

      There is no evidence, which identifies a clinical, and/or biochemical parameter, which is best for assessing hydration status in the older adult. One positive quality study suggested ranges of Psg, which may be useful for assessing volume depletion in elderly adults.  A neutral quality study found Ucol reflected hydration status (narrow range) as measured by Usg and Uosm in euhydrated, elderly patients.  Based upon a postive quality study, researchers identified the following physical exam data as useful in detecting severe dehydration: dry tongue, longitudinal tongue furrows, dry mucous membranes of nose and mouth, eyes that appear recessed in their sockets, upper body muscle weakness, speech difficulty, and confusion.  A positive quality study found multi-frequency BIA useful in detecting change in hydration status, but a single measurement was a poor indicator of hydration status.  Additional well-controlled studies are needed to validate these findings.

       

    • Grade: III
      • Grade I means there is Good/Strong evidence supporting the statement;
      • Grade II is Fair;
      • Grade III is Limited/Weak;
      • Grade IV is Expert Opinion Only;
      • Grade V is Not Assignable.
      • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
      • Moderate (B) means we are moderately confident in the effect estimate;
      • Low (C) means our confidence in the effect estimate is limited;
      • Very Low (D) means we have very little confidence in the effect estimate.
      • Ungraded means a grade is not assignable.