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Urology and Renal

An Advanced Instruments osmometer is an indispensable aid to understanding proper renal function, the differing responses of serum and urine to water load and deprivation, and to making an appropriate diagnosis. The provision of a calculated osmolality, by an automated electrolyte analyzer, does not absolve the pathologist of the need to measure osmolality directly. To the contrary, much useful information can be gained by an investigation of the osmotic gap.

  • Differential Diagnosis of Renal Malfunction: Urine and serum osmolality respond differently to water overload, water deprivation, diuretics, anti-diuretic hormone (ADH) and insulin.
  • Uremia: The accumulation of unmeasured metabolites in the blood can be an early indication of uremia. The difference between measured and calculated osmolality can determine the accumulation of unmeasured metabolites in the blood. Once baseline electrolyte levels are established, osmolality can be used to monitor the progress of the uremic patient.
  • Osmotic Gap and Free Water Clearance: Clearance can be calculated immediately from urine and serum osmolality, providing the earliest marker of tubular damage.
  • Renal Dialysis: In patients with known renal disease, elevated serum osmolality can indicate the need for dialysis. During therapy with diuretics, dialystate osmolality can be used to monitor progress.