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Diabetes Mellitus Urine Specific Gravity

Diabetes Mellitus Glossary

Diabetes Mellitus Glossary

Occurs due to excessive growth hormone production by the pituitary gland dueto a pituitary adenoma. Also known as pituitary gigantism. The main signs includethickening of the skin, soft tissues and bones of the head and feet. There isalso hypertension and insulin resistance Former term for type 2 or non-insulin-dependent diabetes. Albuminuria: A condition in which the urine has more than normal amounts ofa protein called albumin. Albuminuria may be a sign of diabetic nephropathy(kidney disease). A type of cell in the pancreas. Alpha cells make and release a hormone calledglucagon. The body sends a signal to the alpha cells to make glucagon when bloodglucose concentrations fall too low. Glucagon reaches the liver and tells itto release glucose into the bloodstream for energy. A metabolic disorder resulting in deficient secretion of antidiuretic hormone(ADH or vasopressin). This results in the failure of tubular reabsorption ofwater in the kidney. Polyuria (urine has a very low specific gravity) and polydipsiaresults. There is no glucose present in the urine. A condition characterized by Hyperglycaemia resulting from the body's inabilityto use blood glucose for energy. In insulin-dependent (type 1) diabetes, thepancreas no longer makes insulin and therefore blood glucose cannot enter thecells to be used for energy. In non-insulin dependent (type 2) diabetes, eitherthe pancreas does not make enough insulin or the body is unable to use insulincorrectly. An emergency condition in which extremely high blood glucose levels, along witha severe lack of insulin, result in the breakdown of body fat for energy andketones accumulate in the blood and urine. Signs of DKA include vomiting, fruitybreath odor, and rapid breathing. Untreated DKA can lead to coma and death. An intermediat Continue reading >>

Urine Specific Gravity

Urine Specific Gravity

For explanation of the ratio of densities of two materials, see Relative density. Reading of a urine specific gravity of ~1.024 via a handheld refractometer. SG measurement is taken by reading the boundary between the dark and light fields against the graduations on the left column. Specific gravity, in the context of clinical pathology, is a urinalysis parameter commonly used in the evaluation of kidney function and can aid in the diagnosis of various renal diseases. Background[edit] For background on kidney function, see Renal function. One of the main roles of the kidneys in humans and other mammals is to aid in the clearance of various water-soluble molecules, including toxins, toxicants, and metabolic waste. The body excretes some of these waste molecules via urination, and the role of the kidney is to concentrate the urine, such that waste molecules can be excreted with minimal loss of water and nutrients. The concentration of the excreted molecules determines the urine's specific gravity. In adult humans, normal specific gravity values range from 1.000 to 1.030. Specific gravity and disease[edit] Adults generally have a specific gravity in the range of 1.000 to 1.030[1] Increases in specific gravity (hypersthenuria, i.e. increased concentration of solutes in the urine) may be associated with dehydration, diarrhea, emesis, excessive sweating, urinary tract/bladder infection, glucosuria, renal artery stenosis, hepatorenal syndrome, decreased blood flow to the kidney (especially as a result of heart failure), and excess of antidiuretic hormone caused by Syndrome of inappropriate antidiuretic hormone.[2] A specific gravity greater than 1.035 is consistent with frank dehydration.[3] In neonates, normal urine specific gravity is 1.003. Hypovolemic patients usually have Continue reading >>

Urine Specific Gravity

Urine Specific Gravity

Urine specific gravity (USG) is typically more than 1.030, and it appears that many cats with hypercalcemia can still maximally concentrate their urine if they do not have concurrent CKD. Urine specific gravity (USG) is a comparison of the density of urine to that of water. It is an estimate of urine osmolality (the solute concentration of a solution). Typical Normal Range (US Units; SI Units) 1.020 to 1.050 assuming normal hydration status and no treatments that alter water resorption by the kidney The specific gravity of urine is dependent on the hydration status of the animal and the ability of the kidney to respond appropriately in order to dilute or concentrate urine over that of plasma. Dehydration, marked proteinuria, and marked glucosuria Concentrated urine is commonly seen in horses fed a high percentage of hay and those living in hot environments. USG may be falsely increased 0.003 to 0.005 for every 1g/dL of protein in the urine. USG may be falsely increased 0.004 to 0.005 for every 1g/dL of glucose in the urine. Next Diagnostic Step to Consider if Levels High Marked hyposthenuria (USG 1.0011.005) is rarely seen in horses; however, causes include psychogenic polydipsia, pituitary tumors, and diabetes insipidus. Hyposthenuria (USG <1.008) may be seen in horses with moderate kidney damage (when the ability to concentrate has been lost, but the ability to dilute has not) or with a high water content in the feed (nursing foals or horses at pasture). Isosthenuria (USG 1.0081.014) occurs with renal disease ( >75% nonfunctioning tubules or chronic renal failure), administration of diuretics (furosemide) and hypercalcemia. Hyposthenuria or isosthenuria in the face of dehydration or azotemia supports a diagnosis of renal disease. Next Diagnostic Step to Consider if L Continue reading >>

What Is The Difference In The Specific Gravity Of Diabetes Mellitus And Diabetes Insipidus?

What Is The Difference In The Specific Gravity Of Diabetes Mellitus And Diabetes Insipidus?

Urine specific gravity (SG) is typically normal in diabetes mellitus (sweet urine). By definition urine is dilute or low SG in diabetes insipidus (tasteless or insipid urine); the kidneys are unable to produce concentrated urine. Continue reading >>

Rapid Microalbuminuria Screening In Type 2 Diabetes Mellitus: Simplified Approach With Micral Test Strips And Specific Gravity

Rapid Microalbuminuria Screening In Type 2 Diabetes Mellitus: Simplified Approach With Micral Test Strips And Specific Gravity

Rapid microalbuminuria screening in type 2 diabetes mellitus: simplified approach with Micral test strips and specific gravity Correspondence and offprint requests to: Chirag Parikh, MD, PhD, Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Box C281, 4200 E. 9th Avenue, Denver, CO 80262, USA. Email: [email protected] Search for other works by this author on: Nephrology Dialysis Transplantation, Volume 19, Issue 7, 1 July 2004, Pages 18811885, Chirag R. Parikh, Michael J. Fischer, Raymond Estacio, Robert W. Schrier; Rapid microalbuminuria screening in type 2 diabetes mellitus: simplified approach with Micral test strips and specific gravity, Nephrology Dialysis Transplantation, Volume 19, Issue 7, 1 July 2004, Pages 18811885, Background. Microalbuminuria is known to be a harbinger of serious complications in type 2 diabetes mellitus. Since medical intervention at the onset of microalbuminuria can be critical in reducing these adverse outcomes, it is widely agreed that type 2 diabetic patients should be screened for microalbuminuria. The purpose of the present study is to evaluate Micral test strips in conjunction with a urine specific gravity determination as a rapid and accurate method for detecting microalbuminuria in type 2 diabetic patients. Methods. In this prospective study, a total of 444 urine samples of type 2 diabetic patients were obtained from the ABCD study cohort for analysis. Urinary albumin concentrations were determined using Micral test strips and compared to results measuring albumin by the immunoturbidimetry method of timed collections. Urine specific gravity was measured by a standard urine dipstick. Results. The performance characteristics of the Micral test strips for detecting microalbuminuria (303 Continue reading >>

The Value Of Urine Specific Gravity In Detecting Diabetes Insipidus In A Patient With Uncontrolled Diabetes Mellitus

The Value Of Urine Specific Gravity In Detecting Diabetes Insipidus In A Patient With Uncontrolled Diabetes Mellitus

Go to: A 46-year-old woman was referred to our hospital because of worsening polyuria and polydipsia of 2 months duration. She had a 10-year history of type 2 diabetes mellitus, with poor glycemic control that required insulin. The patient drank an average of 5 L/d and her urine output was almost the same. Blood sampling for routine laboratory values were: hemoglobin (Hb), 8.8 mmol/L; platelet count (Plt), 230,000 per mm3; white blood cells (WBC), 6,320 per mm3; creatinine, 98 μmol/L; urea nitrogen, 5.2 mmol/L; uric acid, 351 μmol/L; aspartate transaminase (AST), 0.35 μkat/L; alanine transaminase ALT, 0.47 μkat/L; Na, 132 mmol/L; K, 4.5 mmol/L; glucose, 19.5 mmol/L (351 mg/dL); Ca, 2.3 mmol/L; albumin, 43 g/L; erythrocyte sedimentation rate, 19 mm/h; C-reactive protein 2.1 mg/L; and an HbA1C of 0.0107 Hb fraction. Urine analysis revealed +3 for glucose. A spot urine analysis revealed a urine specific gravity of 1.008 and a 24-hour urine collection revealed a urine specific gravity of 1.007 [reference range: 1.010 to 1.025].3,4 On repeated urine analysis, a 24-hour urine collection revealed a urine specific gravity of 1.008. Therefore, we suspected that diabetes insipidus might be the underlying cause, owing to the presence of a persistently low urine specific gravity. A urine and plasma osmolality was subsequently performed, which were 138 and 285 mmol/kg, respectively. These findings were consistent with diabetes insipidus. A water deprivation test was then performed. No significant increase occurred, either in urine specific gravity or urine osmolality. After the administration of desmopressin, urine specific gravity increased to 1.019 (in a 24-hour urine collection) and urine osmolality increased to 488 mmol/kg. In view of these results, a diagnosis of central di Continue reading >>

Feline Diabetes Mellitus Part 1

Feline Diabetes Mellitus Part 1

Diabetes mellitus (DM) in cats is similar to human Type 2 diabetes in humans. The causes in cats include: Obesity Inactivity High carbohydrate food Pancreatitis (probably exacerbated by grain in cat food) Hyperthyroidism Hypersomatotropism (large cats) caused by excessive pituitary growth hormone secretion. These conditions all increase blood glucose (BG) or insulin resistance. The first four predispositions can be eliminated by feeding grain-free moist cat food. Hyperthyroidism can be controlled. Hypersomatotropism is untreatable at present except at a couple of universities that ablate the pituitary gland using either surgery or stereoscopic radiation therapy. Pathophysiologically, diabetes mellitus in cats is a combination of chronic hyperglycemia due to the feline deficiency in glucose oxidase and excessive carbohydrate ingestion, and/or thyroid or somatotropin hormone excess, and insulin resistance. Hyperglycemia leads to pancreatic islet beta cell toxicity and exhaustion. Rapidly bringing the BG under control often allows the pancreatic islet beta cells to recover their insulin-secreting ability with resulting normoglycemia. The accurate diagnosis of diabetes mellitus and all complications is essential. Typical history and physical findings are polyphagia, polydipsia, polyuria, weight loss and decreased activity. If the diabetes has been present for many weeks, the cat may show hind limb plantigrade stance and joint sensitivity (pain while being restrained for blood collection). Cats are predictably unpredictable, so some diabetic felines are inappetent rather than polyphagic, more active rather than less, and/or gain weight instead of losing body condition. Often, owners are unaware of increased drinking and urinating. Early cases may have only mild weight loss. Continue reading >>

Free Laboratory Science Flashcards About Boc Urinalysis

Free Laboratory Science Flashcards About Boc Urinalysis

A patient with uncontrolled diabetes mellitus will most likely have: pale urine with a high specific gravity. Due to polyuria and increased glucose in urine. While performig and analysis of a bay's urine, the technologist notices the specimen to have a "mousy" odor. Of the following substances that may be excreted, the one that most characteristically produces this odor is: phenylpyruvic acid. Phenylketonuria is a genetic disorder that results in a urine with a mousy odor. Acetone has a fruity odor, Bacteria can produce ammonia odor. Porphyrin has no odor. An ammonia-like odor is characteristically associated with urine from patients who: have an infection with Proteus spp. Proteus spp. is urease positive. Proteus excrete urease, and urease breaksdown ammonia. Urine that develops as a port wine color after standing may contain: porphyrins. Melanin is black, bilirubin is amber/brown. Acid urine that contains hemoglobin will darken on standing die to the formation of: Urine from a 50-year-old man was noted to turn dark red on standing. This change is caused by: The clarity of a urine sample should be determined: following thorough mixing of the specimen. Milky urine from a 24 year old woman would most likely contain: A brown-black urine would most likely contain: The yellow color of urine is primarily die to: specific gravity. Both measure the solutes in a urine. Urine specific gravity is an index of the ability of the kidney to: concentrate the urine. Specific gravity relates to H2O ONLY. To prepare a solution appropriate for quality control of the refractometer, a technician should use: A urine's specific gravity is directly proportional to its: Use of a reftactometer over a urinometer is preferred due to the fact that the refractometer uses: a small volume of urine an Continue reading >>

Urine Specific Gravity: Normal Range, Fluctuations, And Causes

Urine Specific Gravity: Normal Range, Fluctuations, And Causes

This lesson will discuss a test known as urine specific gravity. You'll learn the normal values of urine specific gravity as well as the major causes of its abnormal elevation or decrease. The Color of Urine Believe it or not, urine, normally a light straw color, is something that can come in many different colors, from almost as clear as water to dark yellow to white to red to almost black. Of course, as you can only imagine, most of those colors signify a big problem is going on. It's important that you learn that even seemingly normal-looking urine, in terms of its color, may sometimes actually hide a big problem that can be diagnosed with a specific test we're going to go over. What Is Urine Specific Gravity? This test is known as urine specific gravity, and it is a test that measures the concentration of solutes in the urine. Solutes, in case you didn't know, are substances that are dissolved within something. For example, sugar becomes a solute when dissolved in water. In fact, sugar can actually sometimes be found in urine, as per the famous disease called diabetes mellitus. Be that as it may, normal urine specific gravity, more quickly abbreviated as USG or SG, is approximately 1.005-1.030. At this point, you should be wondering where in the world these numbers came from. It's simple, really. This test is comparing the density of urine to the density of distilled water, the latter of which is set at 1.000. So, water has a specific gravity of 1.000, but because urine is mainly water with some additional stuff like electrolytes dissolved within it, thereby increasing its density compared to pure water, USG can never be less than 1.000. Increased Urine Specific Gravity As a rough guide here, if you've ever had dark-colored urine, it's probably because your urine wa Continue reading >>

Urinary System (lab 17)

Urinary System (lab 17)

Layers of urinary bladder from deep to superficial What kind of tissue makes up the adventitia of urinary bladder? What about the mucosa? Two layers of longitudinal muscle around an inner layer of circular muscle Tube responsible for conducting urine from urinary bladder to outside of body Used in transmission of semen from vas deferens to outside of body Male urethra is longer = greater surface area for bacteria to be flushed away during urination Why do women contract UTIs more than males? Inferior to opening between urethra and urinary bladder Opens when external urethral sphincter opens Causes opening of internal urethral sphincter and contraction of detrusor muscle Indicates fistula (abnormal hole) between urethra and large intestine Indicates cystitis (inflammation of urinary bladder due to infection) Measurement of density of urine compared to water What does chronically low specific gravity of urine indicate? Diabetes mellitus if urine volume is high What does high specific gravity of urine indicate? Urine to crystallize forming kidney stones What does chronic high specific gravity of urine cause? Where is most of glucose filtered out of urine at nephron reabsorbed? Does glucose present in urine register on labstix test? Indicates that more glucose is being excreted than can be reabsorbed Common during starvation or low carb diets What two conditions together indicate diabetes mellitus? Erythrocytes too large to fit through pores of glomerulus of nephron Is blood normally a component of urine? Why? What do green spots on a yellow background on labstix indicate? What does a green or blue color of labstix indicate? What can give a false positive of blood in urine? Normal due to pregnancy, exertion, or high protein diet Proteinuria (what is it and what causes it) Continue reading >>

Diabetes Insipidus Urine Specific Gravity

Diabetes Insipidus Urine Specific Gravity

Urine specific gravity is a laboratory test, ordered by a medical provider, which shows the concentration levels of all chemical particles that happen to be in the urine. Once a urine sample is provided, this test can be performed right away. A color-sensitive pad is dipped into the urine and the color changes which occur will let the provider know what your estimated results happen to be. Laboratories also use a refractometer to project light through the urine in order to determine its density. This method is more reliable than the dipstick testing and is the most common form of determining a person’s diabetes insipidus urine specific gravity. What Do the Urine Specific Gravity Results Mean? Density levels are based on a ratio of 1. Water would have a density of 1.000. This means any results which are closer to 1.000 mean that there are fewer contaminants in the urine and that the body is functioning with normalcy. Most laboratories interpret the range for urine specific gravity as being 1.002-1.030. This would indicate that a patient’s kidneys were functioning at a normal level. Low urine specific gravity results are typically 1.001-1.003. Anything above 1.010 may indicate that there is mild dehydration present, while higher numbers indicate that more severe dehydration is taking place. Results that are above 1.030 are considered to be high. Specific substances in the urine will also cause higher urine specific gravity results. Red blood cells, white blood cells, proteins, glucose, crystals, and even bacteria will all cause the results to be higher. Most people will never have a result above 1.035. This indicates that the test was either contaminated or that blood glucose levels are under very poor control. If there is a suspicion of high glucose or protein levels Continue reading >>

Renal Fellow Network: Urinalysis - Concentration

Renal Fellow Network: Urinalysis - Concentration

Here are some simple facts about urine specific gravity, osmolality and their determination from the urinalysis. The reference substance for comparative purposes is water, which therefore has a specific gravity of 1.000. The so-called normal ranges are completely dependent on the amount of fluid ingested and solute excreted. Therefore, for example, uncontrolled diabetes mellitus may have a high urine specific gravity (due to the high amounts of glucosuria), as well volume depletion states and proteinuric conditions. Low urine specific gravity may be caused by excessive fluid intake, diabetes insipidus and diuretics, which all cause a relatively dilute urine to be formed. Proximal tubular injury (e.g. acute tubular necrosis) may interfere with urinary concentrating capabilities, leading to isosthenuria (a specific gravity of 1.007-1.010). This is a set of circumstances whereby the final urine concentration is essentially equal to that of the glomerular filtrate produced at the early proximal tubule. Note there are potential false elevations in urine specific gravity, many of which are caused by radiographic dyes, which can produce readings >1.03, if measured at a time close to the procedure. Specific gravity measured by urine dipstick The reagent strip in the usual urine dipstick actually measures the ionic concentration of urine. The free ions react with a pH indicator in the strip, thereby causing a change in colour, corresponding to the amount of solute present. Obviously, certain molecules may dissociate more freely than others, which can affect how easily they are to detect. Osmolality differs from the specific gravity in that it depends on the amount of solutes, not on their molecular weight. The range of potential osmolality that can be produced by the normal kid Continue reading >>

The Value Of Urine Specific Gravity In Detecting Diabetes Insipidus In A Patient With Uncontrolled Diabetes Mellitus: Urine Specific Gravity In Differential Diagnosis

The Value Of Urine Specific Gravity In Detecting Diabetes Insipidus In A Patient With Uncontrolled Diabetes Mellitus: Urine Specific Gravity In Differential Diagnosis

Abstract When a patient with diabetes mellitus presents with worsening polyuria and polydipsia, what is a sensible, cost-effective approach? We report the unique coincidence of type 2 diabetes mellitus and diabetes insipidus. A 46-year-old woman with poorly controlled type 2 diabetes complained of polyuria with a daily output of 5 L. Although urinalysis demonstrated significant glucosuria, diabetes insipidus was suspected owing to a low urine specific gravity (1.008). The low specific gravity persisted during a water deprivation test. Ultimately, diabetes insipidus was confirmed when urine specific gravity and urine osmolality normalized following desmopressin administration. This case emphasizes the importance of accurately interpreting the urine specific gravity in patients with polyuria and diabetes mellitus to detect diabetes insipidus. Continue reading >>

What Is Diabetes Insipidus?

What Is Diabetes Insipidus?

Diabetes insipidus, not to be confused with the more common diabetes mellitus, is a relatively rare disorder resulting from a failure to produce sufficient amounts of vasopressin, also known as antidiuretic hormone (ADH). Vasopressin, produced by the hypothalamus and secreted by the posterior pituitary gland, helps the kidneys to reabsorb water and maintain proper fluid balance. If the pituitary fails to produce enough ADH, water is not conserved but simply passed through the kidneys and excreted, typically in very large quantities. More rarely, the kidneys fail to respond properly to ADH; this is known as nephrogenic diabetes insipidus. Dehydration is the primary health risk associated with either form. Diabetes insipidus affects both sexes equally. With proper treatment, overall prognosis is good (except in cases caused by cancer). What Causes Diabetes Insipidus? In approximately one third of all cases, the cause of diabetes insipidus is unknown. Hereditary factors may play a role in some cases. Damage to the pituitary gland from a head injury, a hypothalmic tumor, or inflammation, radiation therapy, or surgery may lead to diabetes insipidus. The most frequent cause of nephrogenic diabetes insipidus is therapy with lithium. Tuberculosis Blockage in an artery leading to the brain Symptoms of Diabetes Insipidus Frequent and excessive urination (output may be as high as 25 to 35 quarts within 24 hours and may be as frequent as every 30 minutes, even at night) Extreme thirst Dry skin Constipation Emergency symptoms of dehydration, including dizziness, weakness, and unconsciousness Prevention of Diabetes Insipidus There is no known way to prevent diabetes insipidus. Diagnosis of Diabetes Insipidus Physical examination and patient history are performed. Diagnosis of diabete Continue reading >>

Complete Urinalysis

Complete Urinalysis

The specific gravity of urine is a measurement of the density of urine - the relative proportions of dissolved solids in relationship to the total volume of the specimen. It reflects how concentrated or dilute a sample may be. Water has a specific gravity of 1.000. Urine will always have a value greater than 1.000 depending upon the amount of dissolved substances (salts, minerals, etc.) that may be present. Very dilute urine has a low specific gravity value and very concentrated urine has a high value. Specific gravity measures the ability of the kidneys to concentrate or dilute urine depending on fluctuating conditions. Normal range 1.005 - 1.035, average range 1.010 - 1.025. Low specific gravity is associated with conditions like diabetes insipidus, excessive water intake, diuretic use or chronic renal failure. High specific gravity levels are associated with diabetes mellitus, adrenal abnormalities or excessive water loss due to vomiting, diarrhea or kidney inflammation. A specific gravity that never varies is indicative of severe renal failure. Specific gravity can be determined by either of two methods using a refractometer or a urinometer. a. Refractometer - measures the refractive index of urine which parallels the specific gravity. 1. Collect mid-stream sample of urine in collection cup. 2. Pipette 1-2 drops of urine into the plastic chamber located on the top of the refractometer. Be sure that the plastic is pressed firmly down in place on the refractometer. 3. Determine the specific gravity of the urine by looking through the refractometer and determining the value on the scale on the left hand side. The specific gravity value is where the light and dark intersect on the scale. 4. Clean the refractometer with kimwipes. b. Urinometer - Is a weighted, bulb shape Continue reading >>

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