Osmolality, Osmolarity and Fluid Homeostasis

Authored by Dr Jacqueline Payne, 22 Jun 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Adrian Bonsall, 22 Jun 2017

Osmolality is a measure of the number of particles in a kg of the liquid they are dissoved in. Osmolarity is a measure of the number of particles in a litre of the liquid they are dissolved in. Fluid homeostasis is the term for keeping the concentration of the fluids in the body from changing. It is sometimes also referred to as fluid balance.

Thirsty? Have a drink of water.

The body is amazing. It manages all of the millions of chemical reactions that take place in our body every day. These reactions depend on the concentration of the fluid in our cells and our blood being tightly controlled all day, every day. How does it do this? By making us thirsty when the fluid is tending to become more concentrated and making us pass more urine when it's getting less concentrated. Magic!

There is no need to drink a certain amount of water every day or risk lack of fluid in the body (dehydration), despite what many websites might tell you. Your body will simply tell you if you need to have a drink, as it has been doing for us and all of our ancestors for millennia. Fluid homeostasis is what this is all about.

To understand fluid homeostasis it helps to understand some of the terms that are used when talking about fluid balance. Osmolality and osmolarity are terms to describe how concentrated the body fluids are.

Osmolality

The osmolality of a fluid is a measure of the number of particles per kilogram of the liquid that they are dissolved in (the solute). The number of particles is measured in milliosmoles, which is a measurement widely used in chemistry. The measurement is given in milliosmoles per kilogram, or mOsmol/kg for short.

Osmolality does not depend on the temperature of the liquid. To take an example, if you dissolve 100 g of salt in 1 kg of water, the osmolality would be the same whether or not the water was near freezing point or at body heat. This is the difference between osmolality and osmolarity.

Osmolarity

The osmolarity of a fluid is a measure of the number of particles per litre of the liquid that they are dissolved in (the solute). The number of particles is measured in millimoles, which is another measurement widely used in chemistry. The measurement is given in millimoles per litre, or mmol/L for short.

Osmolarity will change depending on the temperature of the liquid. To take the same example as above, if you dissolve 100 g of salt in 1 kg of water, the osmolarity will decrease very slightly as the liquid warms up. This is because the same weight of water takes up slightly more room as it warms up - it expands.

Because osmolarity changes with temperature, the term osmolality is preferred in medicine.

Fluid homeostasis is the term for the way the body keeps the osmolality of the body fluids within a very narrow range, all the time. The word homeostasis comes from 'homeo' meaning alike or similar and 'stasis' meaning to remain the same. So fluid homeostasis means keeping the fluid the same all the time.

In normal, healthy people the osmolality of the body's fluids is very closely regulated by the body.

As the osmolality goes up

  • You get a desire to drink - thirst.
  • The brain releases a hormone called antidiuretic hormone (ADH) (also known as arginine vasopressin (AVP)).
  • ADH changes the way the kidneys react to blood flowing through them.
  • The kidneys are continuously filtering the blood and can alter how much water is allowed to go into the urine and how much is reabsorbed back into the body.
  • Diuretic essentially means 'to make you pass urine', so antidiuretic hormone (ADH), as the name suggests, stops you making as much urine and so you don't pass as much urine. The urine you do pass will be darker in colour, as it is more concentrated.
  • If you don't pass as much urine, you don't lose as much water.
  • If you don't lose as much water and you have a drink because you are thirsty, there is more water in your body.
  • If there is more water in your body, your osmolality goes down.

As the osmolality goes down

  • The brain stops releasing ADH and you stop feeling thirsty.
  • The kidneys starting making more urine again.
  • You pass more urine.
  • You lose more water from your body.
  • If there is less water in your body, your osmolality goes up again.

And so it continues, all day, every day: your brain and your kidneys tightly controlling the environment inside your cells.

Sometimes. Sometimes not. It depends on what you are doing, how hot it is, how big you are, how old you are ... but your body will tell you if you need a drink, by making you thirsty.

There is a myth that we need to drink 1½ to 2 litres of water a day. It's not known where this figure comes from but it has been described as: 'not only nonsense but ... thoroughly debunked nonsense.' It's certainly a favourite of the bottled water industry. Drinking water is definitely better for us than drinking sugar-filled pop, but for those of us lucky enough to be living in the advanced world, water supplies are closely monitored and very safe.

Except for people who get recurrent kidney stones, there is no evidence that we should drink more than we naturally want. It may even be bad for us: if it makes us feel guilty for not achieving it - and that's not to mention the sleep deprivation from having to get up in the middle of the night, and the urinary incontinence.

Further reading and references

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