The DOI matches its Crossref record; 59 of the 62 references it cites were found in a registry or an index.
Biological variation and diagnostic accuracy of dehydration assessment markers
Open accessAbstract
Background Well-recognized markers for static (one time) or dynamic (monitoring over time) dehydration assessment have not been rigorously tested for their usefulness in clinical, military, and sports medicine communities. Objective This study evaluated the components of biological variation and the accuracy of potential markers in plasma, urine, saliva, and body mass (B(m)) for static and dynamic dehydration assessment. Design We studied 18 healthy volunteers (13 men and 5 women) while carefully controlling hydration and numerous preanalytic factors. Biological variation was determined over 3 consecutive days by using published methods. Atypical values based on statistical deviations from a homeostatic set point were examined. Measured deviations in body fluid were produced by using a separate, prospective dehydration experiment and evaluated by receiver operating characteristic (ROC) analysis to quantify diagnostic accuracy. Results All dehydration markers displayed substantial individuality and one-half of the dehydration markers displayed marked heterogeneity of intraindividual variation. Decision levels for all dehydration markers were within one SD of the ROC criterion values, and most levels were nearly identical to the prospective group means after volunteers were dehydrated by 1.8-7.0% of B(m). However, only plasma osmolality (P(osm)) showed statistical promise for use in the static dehydration assessment. A diagnostic decision level of 301 plusmn 5 mmol/kg was propo…
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“When we take in too little fluid (drink too little) the fluid within and around our cells becomes more concentrated, raising the osmolality of serum and plasma (221)(222)(223)(224).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [221]
In the citing paper
“Their suggested threshold is that serum or plasma osmolality >300 mOsm/kg is classified as dehydrated.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [221]
In the citing paper
“They assessed the range of plasma osmolality in hydrated younger adults, then in the same persons who had been dehydrated, identifying the cut-off that best separated the two states.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [221]
In the citing paper
“Volume depletion (reduced volume of extracellular fluids only, due to loss of fluids and electrolytes, also called salt loss or extracellular dehydration) occurs without raised serum or plasma osmolality”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [221]
In the citing paper
“Threshold values of serum osmolality have been assessed in varied ways, but Cheuvront et al. (221) appear to have developed these most rigorously.”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [221]
In the citing paper
“and following medical conditions resulting in excessive losses of fluid and electrolytes, such as excessive blood loss, vomiting, and diarrhea (221-224).”
From ESPEN practical guideline: Clinical nutrition and hydration in geriatrics (2022) · cites this paper as [221]
Citations
Cites
Hanley, J. A., & McNeil, B. J. (1983) · Radiology · doi:10.1148/radiology.148.3.6878708 · Cited by 7,016
Receiver-operating characteristic (ROC) plots: a fundamental evaluation tool in clinical medicine
ZWEIG, M. H., & Campbell, G. (1993) · Clinical Chemistry · doi:10.1093/clinchem/39.4.561 · Cited by 6,595
American College of Sports Medicine position stand
Otis, C. L. (1997) · Medical Entomology and Zoology · Cited by 4,407
ACSM Position Stand: Exercise and Fluid Replacement
Convertino, V. A., Armstrong, L. E., Coyle, E. F., Mack, G. W., Sawka, M. N., Senay, L. C., & Sherman, W. M. (1996) · Medicine & Science in Sports & Exercise · doi:10.1097/00005768-199610000-00045 · Cited by 1,977
Self-citationExercise and Fluid Replacement
(2007) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0b013e31802ca597 · Cited by 1,497
Self-citationCurrent databases on biological variation: pros, cons and progress
C. Ricós, V. A. (1999) · Scandinavian Journal of Clinical and Laboratory Investigation · doi:10.1080/00365519950185229 · Cited by 987
Generation and Application of Data on Biological Variation in Clinical Chemistry
Fraser, G. G., & Harris, E. K. (1989) · Critical Reviews in Clinical Laboratory Sciences · doi:10.3109/10408368909106595 · Cited by 868
Robertson, G. L., Mahr, E. A., Athar, S., & Sinha, T. (1973) · Journal of Clinical Investigation · doi:10.1172/jci107423 · Cited by 787
Urinary Indices of Hydration Status
Armstrong, L. E., Maresh, C. M., Castellani, J. W., Bergeron, M. F., Kenefick, R. W., LaGasse, K. E., & Riebe, D. A. (1994) · International Journal of Sport Nutrition · doi:10.1123/ijsn.4.3.265 · Cited by 768
Self-citationEdelman, I. S., Leibman, J., O'meara, M. P., & Birkenfeld, L. W. (1958) · Journal of Clinical Investigation · doi:10.1172/jci103712 · Cited by 695
Research works printed but not linked: 2
- Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academies Press, 2005:73–185.
- Institute of Medicine. Hydration status monitoring. In: Monitoring metabolic status: predicting decrements in physiological and cognitive performance. Washington, DC: National Academies Press, 2004:270–80.
Cited by
Sorted by citations
ESPEN guideline on clinical nutrition and hydration in geriatrics
Volkert, D., Beck, A. M., Cederholm, T., Cruz-Jentoft, A., Goisser, S., Hooper, L., Kiesswetter, E., Maggio, M., Raynaud-Simon, A., Sieber, C. C., et al. (2019) · Clinical Nutrition · doi:10.1016/j.clnu.2018.05.024 · Cited by 1,505
Périard, J. D., Eijsvogels, T. M. H., & Daanen, H. A. M. (2021) · Physiological Reviews · doi:10.1152/physrev.00038.2020 · Cited by 774
ESPEN practical guideline: Clinical nutrition and hydration in geriatrics
Volkert, D., Beck, A. M., Cederholm, T., Cruz-Jentoft, A., Hooper, L., Kiesswetter, E., Maggio, M., Raynaud-Simon, A., Sieber, C., Sobotka, L., et al. (2022) · Clinical Nutrition · doi:10.1016/j.clnu.2022.01.024 · Cited by 516
Sawka, M. N., Leon, L. R., Montain, S. J., & Sonna, L. A. (2011) · Comprehensive Physiology · doi:10.1002/cphy.c100082 · Cited by 470
Self-citationDehydration: Physiology, Assessment, and Performance Effects
Cheuvront, S. N., & Kenefick, R. W. (2014) · Comprehensive Physiology · doi:10.1002/cphy.c130017 · Cited by 461
Self-citation
Metadata
- Authors
- Cheuvront, S. N., Ely, B. R., Kenefick, R. W., & Sawka, M. N.
- Affiliations
- U.S. Army Research Institute of Environmental Medicine (US)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2010-09
- Volume
- 92
- Issue
- 3
- Pages
- 565-573
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W1997497052
- Cited by
- 367
- References
- 62
- Citations by year
- 2026: 12 · 2025: 20 · 2024: 26 · 2023: 21 · 2022: 18 · 2021: 29 · 2020: 28 · 2019: 34 · 2018: 26 · 2017: 20 · 2016: 29 · 2015: 28 · 2014: 20 · 2013: 21 · 2012: 23
- FWCI
- 11.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology (medical) › Thermoregulation and physiological responses
- Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Nephrology › Electrolyte and hormonal disorders
- Keywords
- dehydration assessment, biological variation, plasma osmolality, urine specific gravity, body mass, reference change value, diagnostic accuracy, within-person variability, fluid balance, military medicine, sports medicine
- MeSH terms
- Adult, Body Weight, Dehydration, Female, Humans, Male, Osmolar Concentration, Prospective Studies, Reference Values, ROC Curve, Saliva, Specific Gravity, Biomarkers, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
