Athletes’ self-assessment of urine color using two color charts to determine urine concentration

Floris C. Wardenaar, Daniel Thompsett, Kaila A. Vento, Kathryn Pesek, Dean Bacalzo

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Our objective was to determine self-reported accuracy of an athletic population using two different urine color (Uc) charts (8-color vs. 7-color Uc chart). After approval by the Institutional Review Board, members of an athletic population (n = 189, 20 (19–22) year old student-or tactical athletes and coaches, with n = 99 males and n = 90 females) scored their Uc using two charts. To determine the diagnostic value of Uc, results were compared with urine concentration (osmolality and urine specific gravity, USG). Uc was scored slightly darker with the 8-color vs. 7-color Uc chart (2.2 ± 1.2 vs. 2.0 ± 1.2, respectively, p < 0.001), with a moderate correlation between charts (r = 0.76, 95% CI: 0.69–0.81). Bland-Altman analysis showed a weak reporting bias (r = 0.15, p = 0.04). The area under the curve for correct urine sample classification ranged between 0.74 and 0.86. Higher accuracy for both methods was found when Uc scores were compared to USG over osmolality, indicated by 4.8–14.8% range in difference between methods. The optimal Uc cut-off value to assess a low vs. a high urine concentration for both Uc charts varied in this study between 1 and ≤2 while accuracy for charts was similar up to 77% when compared to USG.

Original languageEnglish (US)
Article number4126
JournalInternational journal of environmental research and public health
Issue number8
StatePublished - Apr 2 2021


  • Accuracy
  • Hydration status
  • Osmolality
  • Self-reporting
  • USG
  • Validation

ASJC Scopus subject areas

  • Pollution
  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis


Dive into the research topics of 'Athletes’ self-assessment of urine color using two color charts to determine urine concentration'. Together they form a unique fingerprint.

Cite this