Urine concentration test
A urine concentration test measures the ability of the kidneys to appropriately conserve or excrete water.
Water loading test; Water deprivation test
For this test, the specific gravity of urine, urine electrolytes, and/or urine osmolality are measured before and after one or more of the following:
- Water loading -- drinking large amounts of water or receiving fluids through a vein
- Water deprivation -- not drinking fluids for a certain amount of time
- ADH administration -- receiving antidiuretic hormone (ADH), which should cause the urine to become concentrated
After you provide a urine sample, it is tested right away. For urine specific gravity, the health care provider uses a dipstick made with a color-sensitive pad. The color the dipstick changes to tells the provider the specific gravity of your urine. The dipstick test gives only a rough result. For a more accurate specific gravity result or measurement of urine electrolytes or osmolality, your health care provider will send your urine sample to a lab.
If needed, your health care provider may ask you to collect your urine at home over 24 hours. Your provider will tell you how to do this. Follow instructions exactly so that the results are accurate.
Eat a normal, balanced diet for several days before the test. Your health care provider will give you instructions for water loading or water deprivation.
Your health care provider will ask you to temporarily stop any medicines that may affect the test results. Be sure to tell your provider about all the medicines you take, including dextran and sucrose. Do not stop taking any medicine before talking to your doctor.
Also tell your provider if you recently received intravenous dye (contrast medium) for an x-ray. The dye can also affect test results.
The test involves only normal urination. There is no discomfort.
This test is most often done if your doctor suspects central diabetes insipidus. The test can help tell it apart from nephrogenic diabetes insipidus.
This test may also be done if you have signs of SIADH (syndrome of inappropriate ADH).
In general, normal values for specific gravity are as follows:
- 1.000 to 1.030 (normal specific gravity)
- 1.001 after drinking excessive amounts of water
- More than 1.030 after avoiding fluids
- Concentrated after receiving ADH
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.
Increased urine concentration may be due to different conditions, such as:
- Heart failure
- Loss of body fluids (dehydration) from diarrhea or excessive sweating
- Narrowing of the kidney artery (renal arterial stenosis)
Sugar, or glucose, in the urine
- Syndrome of inappropriate antidiuretic hormone secretion (SIADH)
Decreased urine concentration may indicate:
- Diabetes insipidus
- Drinking too much fluid
- Kidney failure (loss of ability to reabsorb water)
- Severe kidney infection (pyelonephritis)
There are no risks with this test.
Gerber GS, Brendler CB. Evaluation of the urologic patient: history, physical examination, and urinalysis. In: Wein AJ, Kavoussi LR, Novick AC, et al., eds. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 3.
McPherson RA, Ben-Ezra J. Basic examination of urine. In: McPherson RA, Pincus MR, eds. Henry’s Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, Pa: Elsevier Saunders; 2011:chap 28.
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.
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