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The NKTI Medical Laboratory is pleased to inform you that we are offering Osmolality Test.


CLINICAL APPLICATIONS OF OSMOLALITY DETERMINATION:

A. EMERGENCY MEDICINE:

• Alcohol intoxication – elevated serum osmolality can be an indication of intoxication
• Drug Intoxication screening- Possible ingestion of substances such as methanol,ethylene glycol,isopropanol,propylene glycol and paraldehyde is indicated by elevated serum osmolality when glucose/BUN/ Na+ are normal and there is no evidence of alcohol intake.
• Head injury/Shock – When normal CNS and renal homeostatic mechanisms are unresponsive,serum and urine osmolality can provide rapid determination of appropriate IV therapy. In use of mannitol for treatment of brain swelling,osmolality guides appropriate usage of drug.
• Coma- Very high serum osmolality could indicate renal impairment, drug overdose or diabetes mellitus.
• Non-ketotic diabetic coma – In cases of markedly elevated blood sugar, but with little or no ketosis, osmolality helps to establish the diagnosis.

B. INTERNAL MEDICINE / ENDOCRINOGY

• Hyper/hyponatremia – osmolality differentiates between real and factitious hyponatremia. Urine osmolality helps identify pathogenesis of hypo and hypernatrenia.
• Inappropriate ADH syndrome –Serum and urine osmolality help determine whether SIADH is present in a patient with normal blood volume.
• ADH Therapy – Urine osmolality provides a rapid measure of patient response, assisting thereapy modification.
• Diabetes insipidus- Urine osmolality can measure the effects of human factors and offers rapid determination of the disease’s etiology.
• Insulin therapy- Osmolality provides rapid assessment of the effectiveness of insulin therapy.
• Differential diagnosis of polyuria – Osmolality can help to differentiate between diabetes insipidus and psychogenic polyuria.

C. UROLOGY AND RENAL FUNCTION

• Renal malfunction differential Diagnosis. – Urine and serum osmolality respond differently to water overload, water deprivation, diuretics, antidiuretic hormone (ADH) and insulin.
• Uremia – The difference between measured and calculated osmolalities can determine between 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.
• Osmolal 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, dialysate osmolality can be used to monitor progress.

D. SURGERY / CRITICAL CARE

• Hypovolemic shock prevention – Osmolality can be used to monitor perfusate during coronary bypass or renal surgery to avoid hypovolemic shock.
• Electrolyte / metabolite imbalance – Osmolality offers rapid detection of post-surgery electrolyte/metabolite imbalance. In urologic surgery, the difference between calculated and measured osmolality can be used to estimate absorption of irrigation fluid.
• IV therapy – Osmolality can help monitor and manage IV therapy
• Liver transplant – Large increases in osmolality can occur due to blood loss or transfusion, changes in serum sodium levels, or the administration of sodium bicarbonate.

E. OBSTETRICS/GYNECOLOGY

• Pre-eclamptic patients – Osmolality can help assess renal function,fluid balance and electrolyte balance.

For more information, please call Tel. no. 981-0300 / 0400 local 1056, Clinical Chemistry Section or visit our website at www.nktilab.com





  
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National Kidney and Transplant Institute, East Avenue Quezon City Philippines 1100