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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.

Osmolality can also be measured with a urine test.

How the Test is Performed

How to Prepare for the Test

Follow any instructions from your health care provider about not eating before the test. Your provider may tell you to temporarily stop taking any medicines that may interfere with test results. Such medicines may include water pills (diuretics).

How the Test will Feel

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. This soon goes away.

Why the Test is Performed

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

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 Results

Normal values range from 275 to 295 mOsm/kg (275 to 295 mmol/kg).

Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples. Talk to your provider about the meaning of your specific test results.

What Abnormal Results Mean

A higher than normal level may be due to:

Lower than normal levels may be due to:

  • ADH oversecretion
  • Adrenal gland not working normally
  • Conditions linked to lung cancer (causing syndrome of inappropriate ADH production, or SIADH)
  • Drinking too much water or fluid
  • Low sodium level (hyponatremia)
  • SIADH, condition in which the body makes too much ADH
  • Underactive thyroid gland (hypothyroidism)

Risks

There is little risk involved with having your blood taken. Veins and arteries vary in size from one patient to another and from one side of the body to the other. Taking blood 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 lightheaded
  • Multiple punctures to locate veins
  • Hematoma (blood accumulating under the skin)
  • Infection (a slight risk any time the skin is broken)

Images

References

Oh MS, Briefel G. 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. 23rd ed. St Louis, MO: Elsevier; 2017:chap 14.

Verbalis JG. Disorders of water balance. In: Yu ASL, Chertow GM, Luyckx VA, Marsden PA, Skorecki K, Taal MW, eds. Brenner and Rector's The Kidney. 11th ed. Philadelphia, PA: Elsevier; 2020:chap 15.

Review Date 7/4/2019

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.