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First-Morning Urine Specific Gravity and Enuresis in Preschool Children

Michael Macknin, MD

Department of Pediatrics and Adolescent Medicine, Cleveland Clinic Foundation, Cleveland, Ohio

Sharon V. Medendorp, MPH

Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio

Diane Jahnke, LPN

Department of Pediatrics and Adolescent Medicine, Cleveland Clinic Foundation, Cleveland, Ohio

The object of the study was to determine whether a first-morning urine specific gravity of less than or equal to 1.015 was associated with enuresis in children 3 to 6 years old. Parents of preschool children seen at the Cleveland Clinic Foundation during a 5-month period completed a questionnaire concerning bed-wetting and voiding habits of their child and collected first-morning urine specimens for specific gravity analysis. Of 101 children, 12 had a urine specific gravity of less than or equal to 1.015 (11.9%), including seven of 73 (9.6%) nonbed-wetters, two of 19 (10.5%) bed-wetters by history (who did not wet their beds on the night of the study), and three of nine (33.3%) bed-wetters (who wet their beds on the night of the study). The 73 nonbed-wetters (72.3%) had a mean (±standard deviation) urine specific gravity of 1.022 (±0.006); 19 bed-wetters by history (18.9%) had a mean urine specific gravity of 1.024 (±0.006); and nine bed-wetters (8.9%) had a mean urine specific gravity of 1.019 (±0.005). The groups' mean urine specific gravities were not significantly different (p=O.lO) and the enuretic children were not more likely to have first-morningvoid urine specific gravity of less than or equal to 1.015 than nonenuretic children (p=0.14). Enuretic children who wet their beds on the night of the study had lower mean urine specific gravity than nonbed-wetters although the difference was not significant. Therefore, we do not recommend routine use of first warning void urine specific gravity analysis for predicting presence or absence of enuresis.

Clinical Pediatrics, Vol. 37, No. 12, 719-724 (1998)
DOI: 10.1177/000992289803701202


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