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    127 Urine specific gravity (USG)

    127 Urine specific gravity (USG)

    Urine specific gravity: normal range 1.005–1.030, dilute and concentrated urine and their causes.

    Urine specific gravity (USG) compares the density of urine with that of water and reflects the concentration of dissolved substances in urine. It shows how well the kidneys concentrate or dilute urine according to the body's water balance, under the control of antidiuretic hormone (vasopressin). When the body needs to save water, urine becomes concentrated and USG rises; when there is excess water, urine is dilute and USG falls. It is a routine part of urinalysis.

    UrinalysisKidneyWater balance
    Normal range1.005–1.030
    Water1.000
    Fixed ≈ 1.010isosthenuria (kidney damage)
    Measured bydipstick, refractometer
    Urine specific gravity scale: below 1.005 very dilute, 1.005 to 1.030 normal, above 1.030 very concentrated Urine specific gravity Very dilute below 1.005 1.005 Normal 1.005–1.030 1.030 Concentrated above 1.030
    Figure 1. Urine specific gravity zones. A single value must be interpreted with fluid intake; dipstick results are only approximate.

    Clinical significance

    Low USG (dilute urine)

    Large fluid intake, diuretics, diabetes insipidus (lack of or resistance to antidiuretic hormone), chronic kidney disease with loss of concentrating ability, primary polydipsia. A USG fixed near 1.010 regardless of fluid intake suggests advanced kidney damage.

    High USG (concentrated urine)

    Dehydration (fever, sweating, vomiting, diarrhoea), heart failure, inappropriate ADH secretion (SIADH), glucose in urine (uncontrolled diabetes), protein in urine, contrast agents after imaging.

    Specific gravity is affected by large molecules (glucose, protein, contrast); urine osmolality is a more accurate measure of concentration when precise assessment is needed.

    When to see a doctor

    Excessive thirst and passing large amounts of urine, very dark urine despite drinking, or swelling and reduced urine output need medical assessment.

    References

    This article is for general information and does not replace a consultation with a doctor. Laboratory results must be interpreted by a physician together with symptoms and other tests.

    Published on 12 May 2024