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Some authors argue that the formula 1.86(Na+K)+1.15(Glu/18)+(Urea/6)+14 is the most precise of them. Many other formulas have been developed and used over the years, but the simple Smithline-Gardner formula remains the most useful. concluded that the best formula was the simple Smithline-Gardner formula, where the plasma concentrations are measured in mmol/l. In 1976, Smithline and Gardner, proposed to use serum osmolality = 2(Na) + glucose/18 + BUN/1.8 as a simpler formula. The 1975 Dorwart and Chalmers formula, serum osmolality = 1.86(Na) + (glucose/18) + (BUN/2.8) + 9 had been often used to calculate the plasma osmolality. Specific therapies and toxins that affect an individual’s fluid balance should also be evaluated with serum osmolality. The blood urea nitrogen (BUN) measurement is important for calculating the serum osmolality.
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Serum osmolality is affected by the concentration of blood chemicals like chloride, sodium (Na), proteins, bicarbonate, and glucose. Serum and urine osmolality tests are usually measured together to be compared and reach the diagnosis of any disease that influences osmolality. It is routinely measured in clinical laboratories for the differential diagnosis of disorders related to the hydrolytic balance regulation, renal function, and small-molecule poisonings. SIADH sometimes occurs with lung disease, cancer, diseases of the central nervous system, or the use of certain medicines.Osmolality indicates the concentration of all the particles dissolved in body fluid. A condition called syndrome of inappropriate antidiuretic hormone secretion (SIADH).This can be caused by some medicines, including diuretics and certain blood pressure medicines. A rare disease, such as diabetes insipidus, that causes the kidneys to lose water and produce large amounts of urine.These include ethanol (the alcohol in alcoholic drinks), rubbing alcohol (isopropanol), wood alcohol (methanol), and antifreeze (ethylene glycol). This can cause a buildup of urea in the blood. This may be caused by problems such as poorly controlled diabetes.
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