| Subject | Contents |
| Definition | This test measures the osmolality (concentration of particles) of the urine. |
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| How the test is performed | Child or adult: Collect a "clean-catch" (midstream) urine sample. To obtain a clean-catch sample, men or boys should wipe clean the head of the penis . Women or girls need to wash the area between the lips of the vagina with soapy water and rinse well. As you start to urinate, allow a small amount to fall into the toilet bowl (this clears the urethra of contaminants). Then, in a clean container, catch about 1 to 2 ounces of urine and remove the container from the urine stream. Give the container to the health care provider or assistant. Infant: Thoroughly wash the area around the urethra. Open a urine collection bag (a plastic bag with an adhesive paper on one end), and place it on your infant. For males, the entire penis can be placed in the bag and the adhesive attached to the skin. For females, the bag is placed over the labia. Place a diaper over the infant (bag and all). Check your baby frequently and remove the bag after the infant has urinated into it. For active infants, this procedure may take a couple of attempts -- lively infants can displace the bag, causing an inability to obtain the specimen. The urine is drained into a container for transport back to the health care provider. |
| How to prepare for the test | No special preparation is necessary for this test, but if the collection is being taken from an infant, a couple of extra collection bags may be necessary. |
| How the test will feel | The test involves normal urination, and there is no discomfort. |
| Why the test is performed | Osmolality measures the concentration of particles in a solution (in this case, urine). Osmolality (particles/kg water) and osmolarity (particles/liter of solution) are sometimes confused -- but for dilute fluids (such as urine), they are essentially synonymous. Osmolality is a more exact measurement of urine concentration than specific gravity because specific gravity depends on the precise nature of the molecules present in the urine. Specific gravity also requires correction for the presence of glucose or protein . |
| Normal Values | Normal values are as follows: Random specimen: 50 to 1400 mOsm/kg 12 to 14 hour fluid restriction: greater than 850 mOsm/kg Note: mOsm/kg = milliosmoles per kilogram |
| What abnormal results mean | Abnormal results are indicated as follows: Greater-than-normal measurements may indicate:Addison's disease (rare) Congestive heart failureShock Syndrome of inappropriate ADH secretion Lower-than-normal measurements may indicate:Aldosteronism (very rare) Diabetes insipidus (rare) Excess fluid intake Renal tubular necrosis Severe pyelonephritis Additional conditions under which the test may be performed:Complicated UTI (pyelonephritis)Dilutional hyponatremia (SIADH) |
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