In a series of four blogs, Judith Beurskens talks about her research into the self-measurement of urine samples at home by patients with severe intestinal failure. Judith is a Nursing Specialist at the Department of Stomach, Bowel and Liver Diseases of the Radboud University Medical Center in Nijmegen.
In severe intestinal failure, fluid regulation is of great importance. Due to the high output stoma that many of these patients have, they lose a lot of fluid unnoticed. With a high risk of dehydration and hospitalization, if the cause is not discovered fast.
Judith about this: “What your body does when you are dehydrated is actually trying to retain salt and fluid. Usually, you just pee salt out. If patients have less sodium in their urine, it's a first sign they are retaining fluid.” “If we suspect dehydration, we ask patients to hand in a jar of urine to their GP or a nearby hospital. Because our patients live all over the Netherlands,” continues Judith. Patients can do this throughout the day because it does not necessarily have to be morning urine. After a few days, Radboud UMC receives the results.
"In those days they can become very dehydrated. If that is the case, we advise patients to administer half a litre of extra fluid via the drip themselves. You can also do nothing at all and tell patients: 'grab half a litre of fluid ". But those people often have to take 4 to 5 litres a day.
A disadvantage of this is that patients do not know exactly what caused the lack of moisture. Whether the sodium content of the urine is too low or whether they have a magnesium deficiency, for example.” It is therefore very important for practitioners to know exactly what causes dehydration. If they only find out after a few days because the lab results are only known then, patients often already suffer from severe thirst, cramps, headaches and fatigue, without knowing the exact cause.
“When patients use the Medimate to determine a urine sample themselves, they receive the result within 9 minutes. And they can see for themselves whether the sodium content in the urine is below 20 millimoles per litre,” Judith reports about her research.
Being able to measure urine values yourself at home has many advantages. Both for the patient and the healthcare sector. Because patients don't have to go to the lab. There is no need to wait for the result. This means that the cause of dehydration is responded to very quickly and adequately with the right treatment, which prevents hospital admissions.
“Currently, the patient is often left with complaints as long as the urine measurement is not known. Might even start drinking more, which will only make the situation worse. They lose the extra moisture again through the stoma. This means that extra fluid must be taken in again. Thus, the patient ends up in a vicious circle.
This can be prevented by measuring the urine values faster,” Judith says about her research topic. Read more about her experiences in this article.