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Tuesday, September 2, 2014
Urinary and Genital Disorders (Children)
Very concentrated urine
My 4 year old son drinks alot of liquids daily (mainly water, no sugar drinks) as well as voiding often. Initial urinalysis (at pediatrician`s office) revealed protein and ketones in urine. Urine was very concentrated. Glucose was 104. Urine cultures were negative as was electrolyte panel. A week later, subsequent urinalysis revealed everything was negative but urine remains very concentrated despite amount of fluid consumed. Should we be concerned about the concentrated urine? Does he need further testing?
A concentrated urine usually does not signify any urinary tract problem. On the contrary, dilute urine may be a sign of kidney problems. True "concentration" of urine should be based on a urine test looking for the "specific gravity". It is impossible to truly tell if the urine is concentrated just by its appearence and/or smell. The concentration of the urine can vary throughout the day based on level of hydration. The concentration will be higher in the morning upon arising and may decrease during the day as the child drinks fluid. Protein in the urine can be a sign of kidney disease but this would require a 24 hour collection to assess. It is not at all uncommon for a child to have a little bit of protein in the urine detected on a standard dipstick.
Rama Jayanthi, MD
Clinical Assistant Professor of Urology
College of Medicine
The Ohio State University