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    Osmolality - blood test

    Osmolality is a test that measures the concentration of all chemical particles found in the fluid part of blood.

    A blood sample is needed.

    Do not eat for 6 hours before the test. Your doctor may tell you to temporarily stop taking any medicines that may interfere with test results. Such medicines may include water pills (diuretics).

    When the needle is inserted to draw blood, some people feel moderate pain. Others feel only a prick or stinging sensation. Afterward, there may be some throbbing or a slight bruise. These soon go away.

    This test helps check your body's water balance. Your doctor may order this test if you have signs of any of the following:

    • Low sodium (hyponatremia) or water loss
    • Poisoning from harmful substances such as ethanol, methanol, or ethylene glycol
    • Problems producing urine

    In healthy people, when osmolality in the blood becomes high, the body releases antidiuretic hormone (ADH).

    This hormone causes the kidneys to reabsorb water. This results in more concentrated urine. The reabsorbed water dilutes the blood. This allows blood osmolality to fall back to normal.

    Low blood osmolality suppresses ADH. This reduces how much water the kidneys reabsorb. Dilute urine is passed to get rid of the excess water, which increases blood osmolality back toward normal.

    Normal values range from 275 to 295 milliosmoles per kilogram.

    The examples above are common measurements for results of these tests. Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your doctor about the meaning of your specific test results.

    Higher than normal levels may be due to:

    • Diabetes insipidus
    • High blood sugar level (hyperglycemia)
    • High level of nitrogen waste products in the blood(uremia)
    • High sodium level (hypernatremia)
    • Stroke or head trauma resulting in decreased ADH secretion
    • Water loss (dehydration)

    Lower than normal levels may be due to:

    • ADH oversecretion
    • Adrenal gland not working very well
    • Conditions linked to lung cancer
    • Drinking too much water or dilute fluid
    • Low sodium level (hyponatremia)
    • Underactive thyroid gland

    Risks

    Veins and arteries vary in size from one patient to another and from one side of the body to the other. Obtaining a blood sample from some people may be more difficult than from others.

    Other risks associated with having blood drawn are slight but may include:

    • Excessive bleeding
    • Fainting or feeling light-headed
    • Hematoma (blood accumulating under the skin)
    • Infection (a slight risk any time the skin is broken)

    References

    Oh MS. Evaluation of renal function, water, electrolytes, and acid-base balance. In: McPherson RA, Pincus MR, eds. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 14.

    Pincus MR, Abraham NZ Jr. Toxicology and therapeutic drug monitoring. In: McPherson RA, Pincus MR, eds. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 23.

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                Tests for Osmolality - blood test

                Review Date: 8/4/2013

                Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.

                The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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