@daphne47 The kidney function can indeed bounce around a bit. Things like time of day, your hydration level, what you had to eat in previous 24 hrs can all play a part in the lab results. My drs have always advised me that you look at the trend, not a single value.

To hear your Dr and nurse do not seem to give you satisfactory answers does not surprise me. Nephrology [study of kidneys and the renal system] can be pretty complicated, and there are new advances being made all the time. Many general physicians do not lean towards more specialized education. I am glad you will be seeing a nephrologist end of Dec, but I would still ask the reason for the osmolality test, what they are looking for. If the testing is being done to investigate possible diabetes, are you going to be paired with an endocrinologist?

As far as Dr's working together if they are not part of the same group. I can relate my experience. Previously, I used an HMO for insurance, and was a patient in a very large medical center, where all my specialists were. I grew very dissatisfied with the nephrologist and oncologist, and went outside the plan. Yes, it cost me more in co-pay, but my confidence in them was critical. I made sure everyone had each others' contact info, and requested copies of all lab work and visit notes to keep in my own bag. I had to be my own advocate.

Currently, after moving 800 miles, I am on a PPO plan, where I can choose my Dr's. My oncologist came from a friend's high recommendation, and I chose my nephrologist based on who he is comfortable working/communicating with. I follow his lead as to which imaging center to use, also. No, they are not in the same medical group, but they all talk to each other. I still keep copies of all lab work and chart notes, to fill in as needed.
Ginger