Urine Specific Gravity in PA?

[Guest guest]

Dr. Grim, have you ever used "Urine Specific Gravity" as a marker for PA? I had an appt. today to discuss side effects of T2DM for disability compensation. I met with a PA and he never checked anything he only reviewed my records. When we got to neuropathy he said I hadn't had diabetes long enough, that it took 10 years to see signs of it and that I had gout. (I had never looked gout up so I couldn't argue with him but I can now, I do not have gout!)

I decided to try and establish the first signs of DM and searched Urine Specific Gravity since I remembered that was usually low and I had looked it up once and found diabetes was one of the causes. When I went to Medlineplus to confirm that look at what I found!

Decreased urine specific gravity may be due to:

Aldosteronism (very rare)

Excessive fluid intake

Diabetes insipidus - central

Diabetes insipidus - nephrogenic

Kidney failure

Renal tubular necrosis

Severe kidney infection (pyelonephritis)

I called up all my labs, back to Aug, 2005, and found I had only hit the minimum one time out of 10 different tests! (Normal range = 1.016-1.022, mine 1.005-1.016) The day Cogbill got 0.1 for renin and 5 for aldo (2/22/2007) it was 1.009, how many indicators did she need! (The good thing is that each report has the provider's name so I can ask each of them what they were thinking!)

I wonder if I had something "very rare" back in 2005! I also wonder if this could be a flag to require the doctor to look further! Your thoughts?