Osmolality measures the concentration of particles in solution. Osmolality increases with dehydration (loss of water without loss of solutes) and decreases with overhydration. In healthy people, when osmolality in the blood becomes high, ADH (antidiuretic hormone) is secreted. ADH causes your kidney to reabsorb water. You then pass more concentrated urine. The reabsorbed water dilutes the blood, dropping blood osmolality back to normal. Conversely, low blood osmolality suppresses ADH, reducing how much water the kidney reabsorbs. You pass dilute urine to get rid of the excess water, and blood osmolality increases. Osmolality of the blood also changes if extraneous particles are added. Thus, if ethanol, methanol, ethylene glycol, or other compounds are ingested, the osmolality of the blood increases. Similarly, with diabetes, extra blood glucose increases blood osmolality.
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