The applicability of the urine color scale in pediatric urology

Aims To determine the level of agreement between healthcare professionals, patients and their parents/guardians in the interpretation of the urine color scale (UCS) in cases of urinary dysfunction, analyzing the applicability of the scale as a diagnostic tool determining the hydration status. Methods This was a cross-sectional study involving 5-17-year-old patients with lower urinary tract symptoms (LUTS) and enuresis. The study was conducted in a public healthcare referral center for pediatric urology in the Brazilian state of Bahia between October 2019 and March 2020. The Kolmogorov–Smirnov test was used to assess the distribution of the variables. Agreement was assessed using the kappa coefficient and weighted kappa. The z-test was used to determine significant differences between the kappa and weighted kappa. The statistical analysis was conducted using SPSS, version 14, and significance was established at p < 0.05. Results Forty-four patients were included. The kappa value was 32.4% (p = 0.000) for the agreement between healthcare professionals and patients, 41.9% (p = 0.000) for agreement between healthcare professionals and parents/guardians, and 25.0% (p = 0.001) for agreement between patients and parents/guardians. The weighted kappa was 70.6% (p = 0.000) for agreement between healthcare professionals and patients, 82.4% (p = 0.000) for agreement between healthcare professionals and parents/guardians, and 51.5% (p = 0.001) for agreement between patients and parents/guardians. There was a statistically significant difference in kappa values when the healthcare professionals were compared with the other groups. Conclusions Although there were some inconsistencies in interpretation, the UCS proved to be a useful tool with which to evaluate patients’ hydration status.Summary figureThe Urine Color Scale (UCS), as developed by Armstrong et al. [1].Summary figure