Spot Sample Urine Specific Gravity Does Not Accurately Represent Small Decreases in Plasma Volume in Resting Healthy Males

Abstract

ABSTRACTBackground: Urine specific gravity (USG) is often used to assess hydration status, particularly around athletic competition, but it is unknown whether high USG is indicative of plasma volume (PV) reduction (i.e., hypohydration). We tested the hypothesis that if high USG is reflective of reduced PV, subsequent fluid ingestion would increase PV.Purpose: The purpose of this study was to examine 24-hour changes in USG and PV in individuals presenting with high and low spot USG.Methods: Nineteen healthy males were provided food and water over 24 hours with a total water volume of 35 ml·kg−1 body mass. Absolute PV and blood volume (BV), measured using the CO-rebreathe technique, along with USG were measured before and after a 24-hour intervention period. Based on a preintervention morning spot USG, subjects were post hoc assigned to groups according to USG (≤1.020 or >1.020; low and high USG, respectively).Results: Despite presenting with an elevated spot USG (1.026 ± 0.004), subsequent fluid ingestion over 24 hours did not lead to changes (∆) in PV (−75 ± 234 ml) or BV (−156 ± 370 ml) in the high USG group (p > 0.05). However, a spot USG after the 24-hour intervention in this group decreased (p = 0.018) to a level indicating improved hydration status (1.017 ± 0.007). In the low USG group, there were no changes in PV (−39 ± 274 ml), BV (−82 ± 396 ml), or USG (0.003 ± 0.007) over the 24-hour fluid intervention (all p > 0.05).Conclusions: Despite a high preintervention USG and subsequent decrease after 24-hour fluid intake, measures of PV and BV were not indicative of this seemingly improved hydration status. This suggests that a highly concentrated spot sample USG and subsequent changes are not accurately representative of PV or BV.