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Sodium (Na) in Urine

Test Overview

A test for sodium in the urine is a 24-hour test or a one-time (spot) test that checks how much sodium is in the urine. Sodium is both an electrolyte and a mineral. It helps keep the water (the amount of fluid inside and outside the body's cells) and electrolyte balance of the body. Sodium is also important in how nerves and muscles work.

Most of the sodium in the body (about 85%) is found in blood and lymph fluid. Sodium levels in the body are partly controlled by a hormone called aldosterone, which is made by the adrenal glands. Aldosterone levels tell the kidneys when to hold sodium in the body instead of passing it in the urine. (See a picture of the adrenal glands or the kidneys.) Small amounts of sodium are also lost through the skin when you sweat.

Most foods have sodium naturally in them or as an ingredient in cooking. Sodium is found in table salt as sodium chloride or in baking soda as sodium bicarbonate. Many medicines and other products also have sodium in them, including laxatives, aspirin, mouthwash, and toothpaste.

Too much sodium in the diet may raise blood pressure in some people. For those who have high blood pressure, eating foods with a lot of sodium makes their chance of heart disease, stroke, and kidney damage higher. Heart failure gets worse when too much sodium is eaten. It increases the amount of water the body holds in and this causes swelling of the legs and hands. Some people have problems when they eat more than 4,000 milligrams (mg) of sodium per day.

Low sodium levels are uncommon and most often occur as a side effect of taking medicines that make you urinate more, such as diuretics. Severe diarrhea or vomiting or heavy sweating may also cause low sodium levels.

Why It Is Done

A urine test to check sodium levels is done to:

  • Check the water and electrolyte balance of the body.
  • Find the cause of symptoms from low or high levels of sodium.
  • Check the progress of diseases of the kidneys or adrenal glands.

How To Prepare

You do not need to do anything before having this test.

Talk to your doctor about any concerns you have regarding the need for the test, its risks, how it will be done, or what the results will mean. To help you understand the importance of this test, fill out the medical test information form(What is a PDF document?).

How It Is Done

Urine sodium can be checked in a single urine sample but it is more often measured in a 24-hour urine sample.

Clean-catch midstream one-time urine collection

  • Wash your hands to make sure they are clean before collecting the urine.
  • If the collection cup has a lid, remove it carefully and set it down with the inner surface up. Do not touch the inside of the cup with your fingers.
  • Clean the area around your genitals.
    • A man should retract the foreskin, if present, and clean the head of his penis with medicated towelettes or swabs.
    • A woman should spread open the genital folds of skin with one hand. Then use her other hand to clean the area around the urethra with medicated towelettes or swabs. She should wipe the area from front to back so bacteria from the anus is not wiped across the urethra.
  • Begin urinating into the toilet or urinal. A woman should hold apart the genital folds of skin while she urinates.
  • After the urine has flowed for several seconds, place the collection cup into the urine stream and collect about 2 fl oz (60 mL) of this "midstream" urine without stopping your flow of urine.
  • Do not touch the rim of the cup to your genital area. Do not get toilet paper, pubic hair, stool (feces), menstrual blood, or anything else in the urine sample.
  • Finish urinating into the toilet or urinal.
  • Carefully replace and tighten the lid on the cup then return it to the lab. If you are collecting the urine at home and cannot get it to the lab in an hour, refrigerate it.

Urine collection over 24 hours

  • You start collecting your urine in the morning. When you first get up, empty your bladder but do not save this urine. Write down the time that you urinated to mark the beginning of your 24-hour collection period.
  • For the next 24 hours, collect all your urine. Your doctor or lab will usually provide you with a large container that holds about 1 gal (4 L). The container has a small amount of preservative in it. Urinate into a small, clean container and then pour the urine into the large container. Do not touch the inside of either container with your fingers.
  • Keep the large container in the refrigerator for the 24 hours.
  • Empty your bladder for the final time at or just before the end of the 24-hour period. Add this urine to the large container and record the time.
  • Do not get toilet paper, pubic hair, stool (feces), menstrual blood, or other foreign matter in the urine sample.

How It Feels

There is no discomfort in collecting a one-time or 24-hour urine sample.

Risks

There is no chance for problems in collecting a one-time or 24-hour urine sample.

Results

A test for sodium in the urine is a 24-hour test or a one-time (spot) test that checks how much sodium is in the urine. Sodium is both an electrolyte and a mineral.

Normal

The normal values listed here-called a reference range-are just a guide. These ranges vary from lab to lab, and your lab may have a different range for what's normal. Your lab report should contain the range your lab uses. Also, your doctor will evaluate your results based on your health and other factors. This means that a value that falls outside the normal values listed here may still be normal for you or your lab.

Results are ready in 1 day.

Sodium in 24-hour urine collection
Adult:

40-220 milliequivalents (mEq)/day or 40-220 millimoles (mmol)/day (SI units)
Children:

41-115 mEq/day or 41-115 mmol/day
Sodium in one-time urine sample
Normal:

Greater than 20 milliequivalents per liter (mEq/L)

Many conditions can affect sodium levels. Your doctor will talk with you about any abnormal results that may be related to your symptoms and past health.

What Affects the Test

Reasons you may not be able to have the test or why the results may not be helpful include:

What To Think About

  • Sodium levels can also be measured in a blood test. For more information, see the topic Sodium (Na) in Blood.
  • Doctors may look at urine sodium and blood sodium levels to see whether conditions or medicines may be causing fluid or electrolyte imbalances. Urine sodium levels are often high when blood levels are low or low when blood levels are high. Urine sodium levels are affected by medicines and hormones.
  • To see whether the body is passing too little or too much sodium in the urine, a value called the fractional excretion of sodium (FENa) can be found by looking at the amounts of sodium and creatinine in blood and urine. In a person with kidney failure, a low FENa may mean less blood flow to the kidneys is causing the kidney failure.

References

Other Works Consulted

  • Chernecky CC, Berger BJ (2008). Laboratory Tests and Diagnostic Procedures, 5th ed. St. Louis: Saunders.
  • Fischbach FT, Dunning MB III, eds. (2009). Manual of Laboratory and Diagnostic Tests, 8th ed. Philadelphia: Lippincott Williams and Wilkins.
  • Pagana KD, Pagana TJ (2010). Mosby’s Manual of Diagnostic and Laboratory Tests, 4th ed. St. Louis: Mosby Elsevier.

Credits

By Healthwise Staff
Primary Medical Reviewer E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer Avery L. Seifert, MD - Urology
Last Revised September 1, 2010

Last Revised: September 1, 2010

Author: Healthwise Staff

Medical Review: E. Gregory Thompson, MD - Internal Medicine & Avery L. Seifert, MD - Urology

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