Urine Osmolality Test

Posted by daphne47 @daphne47, Nov 11, 2020

Im new to this whole kidney group, and knowing anything. Just would like a little insight. Im female, in my 30s. I recently discovered repeated lows in my gfr. Did some tests, got results but not much help from gp, waiting for Nephrologist appt. My urine osmoality is low, not serum. Potassium low, took supplements, got normal, stopped them then started falling again. Thinking diabetes insipidus, or something else, not diabetes. Ive taken Lithium 10+ years but my levels are always normal. Im just a little lost and worried, trying to do my research but exhausted. My bp started a high trend again so i just started on medication. I was on meds for high bp a few years ago as well. Dont drink or smoke, but have other health problems. Some autoimmune. Could anyone tell me more about osmoality?? Im a bit confused about having tests that dont make sense.

Hi @daphne47. I can see you are looking for feedback on osmolality and the testing. Members like @kamama94 and @gingerw may be able to provide some helpful information to get started.

Also, you will see that I have updated the title of this post to allow more members to better connect with you and share their experiences.

Can I ask when your Nephrologist appointment is scheduled for? Also, was that the recommended next step from the physician who requested the other labs?

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@amandajro

Hi @daphne47. I can see you are looking for feedback on osmolality and the testing. Members like @kamama94 and @gingerw may be able to provide some helpful information to get started.

Also, you will see that I have updated the title of this post to allow more members to better connect with you and share their experiences.

Can I ask when your Nephrologist appointment is scheduled for? Also, was that the recommended next step from the physician who requested the other labs?

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Yes, she offered the referral after several tests. My appointment is at the end of December.

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@daphne47 I am glad that @amandajro tagged me in this conversation. I have not had this test, and after reading up on what it is, it is a test to check the level of water in your body, among other things. Lithium can have serious side effects of causing kidney damage. Seeing that you talked about other health issues [boy, how I can relate!], things need to be taken as a whole. Are your doctors all talking to each other, and coordinating care? That is important.

Here is an article from healthline.com about osmolarity https://www.healthline.com/health/osmolality-urine

You mentioned kidney function, what is your eGFR? From my standpoint and experience, anything you can do without medication is great. Lose weight if you need to, ramp up exercise, lower sodium intake, eat healthy, work towards a stress-free life as you can. This will help your blood pressure and overall health.
Don't be embarrassed to ask your doctor the reason for the test, and if you have insurance, make sure they will cover it!

How else may I help you today?
Ginger

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My last gfr was 74 at the beginning if this month. But the lowest has been 64, and has bounced around a little. Also did a 24 hr urine test, in which there were some abnormalities. This gp I saw for this I really don't know her. I originally saw her for a H and p for a surgery. Found out my gfr was low and took tests from there. I dont think her nurse knows much, she couldn't answer my questions. They summed it up to being unusual and referring me to a specialist or treating my symptoms. Hmm, ok. Not very helpful. But i got some testing done and now going to most likely a more helpful place. If you know the secret sauce to getting drs to work together that aren't in the same clinic, please, let me know! It's like pulling teeth around here.

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@daphne47

My last gfr was 74 at the beginning if this month. But the lowest has been 64, and has bounced around a little. Also did a 24 hr urine test, in which there were some abnormalities. This gp I saw for this I really don't know her. I originally saw her for a H and p for a surgery. Found out my gfr was low and took tests from there. I dont think her nurse knows much, she couldn't answer my questions. They summed it up to being unusual and referring me to a specialist or treating my symptoms. Hmm, ok. Not very helpful. But i got some testing done and now going to most likely a more helpful place. If you know the secret sauce to getting drs to work together that aren't in the same clinic, please, let me know! It's like pulling teeth around here.

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@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

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@gingerw

@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

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Ya, i do all that too. Ive been my own advocate along time.

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