Sammy found a decreased specific gravity in the urine. This could indicate all of the following EXCEPT:

Sammy found a decreased specific gravity in the urine. This could indicate all of the following EXCEPT:

• A. increased water intake
• B. chronic renal disease
• C. other diseases
• D. shock

Answer: (D)

A decreased urine specific gravity means the urine is dilute, which usually happens when the kidneys aren’t concentrating urine well or when a lot of water is being excreted. Increased water intake naturally results in more water loss in the urine and a lower specific gravity, so a dilute urine is expected. Chronic renal disease damages the kidney’s ability to concentrate urine, leading to a persistently low specific gravity as tubules can’t conserve water effectively. Other diseases that cause polyuria or impair concentrating ability can also produce dilute urine, lowering the SG. Shock, on the other hand, tends to trigger mechanisms that conserve water to maintain blood pressure and perfusion. Antidiuretic hormone is released to retain water, which usually makes the urine more concentrated rather than dilute, at least early on. Only if shock progresses to significant kidney injury would the ability to concentrate fall, so a low specific gravity is not a typical consequence of shock. Therefore, shock is the exception.

A decreased urine specific gravity means the urine is dilute, which usually happens when the kidneys aren’t concentrating urine well or when a lot of water is being excreted.

Increased water intake naturally results in more water loss in the urine and a lower specific gravity, so a dilute urine is expected. Chronic renal disease damages the kidney’s ability to concentrate urine, leading to a persistently low specific gravity as tubules can’t conserve water effectively. Other diseases that cause polyuria or impair concentrating ability can also produce dilute urine, lowering the SG.

Shock, on the other hand, tends to trigger mechanisms that conserve water to maintain blood pressure and perfusion. Antidiuretic hormone is released to retain water, which usually makes the urine more concentrated rather than dilute, at least early on. Only if shock progresses to significant kidney injury would the ability to concentrate fall, so a low specific gravity is not a typical consequence of shock. Therefore, shock is the exception.