What are the causes of elevated urine specific gravity (USG)?

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Last updated: February 14, 2025 • View editorial policy

From the Research

Causes of Elevated Urine Specific Gravity (USG)

The causes of elevated urine specific gravity (USG) can be attributed to various factors, including:

  • Clinical conditions such as uncontrolled diabetes mellitus, nephrotic syndrome, and the administration of intravenous radiocontrast material or saline diuresis 1
  • Heat exposure, as seen in heat-exposed workers, which can lead to kidney damage and elevated USG 2
  • Dehydration or insufficient fluid intake, particularly in individuals who experience significant sweat losses 3
  • High levels of certain substances in the urine, such as protein, glucose, ketones, bilirubin, and urobilinogen, which can affect the correlation between USG and osmolality 4
  • Body composition, specifically fat-free mass, which has been shown to be positively associated with USG in athletes and active adults 5

Factors Affecting USG

Several factors can influence USG, including:

  • Urine osmolality, which has a linear correlation with USG, but can be affected by various clinical conditions 1, 4
  • pH levels, which can impact the correlation between USG and osmolality 4
  • Presence of certain substances in the urine, such as protein, glucose, and ketones, which can affect USG measurements 4
  • Body size and composition, particularly fat-free mass, which can influence USG in athletes and active adults 5
  • Hydration status, which can be affected by fluid intake and sweat losses, and can impact USG measurements 3

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.