Which of the following could indicate Addison’s disease based on urine analysis?

Addison's disease, a form of primary adrenal insufficiency, results from the inadequate production of corticosteroids, particularly cortisol and aldosterone, due to adrenal gland dysfunction. In the context of urine analysis, one significant indication of Addison’s disease is high osmolality.

High urine osmolality reflects the kidneys' ability to concentrate urine, often seen when there is insufficient aldosterone. With Addison's disease, the lack of aldosterone leads to decreased sodium reabsorption and increased excretion of sodium and water, which can result in concentrating the urine. This concentrating ability in the face of adrenal insufficiency can produce urine with high osmolality.

In addition, patients may experience dehydration or volume loss, further contributing to a higher concentration of solutes in the urine. Therefore, in assessing a patient suspected of having Addison’s disease, a urine analysis showing high osmolality can be a strong indicator of this condition.

Interpreting other findings, such as low or normal osmolality, does not fit the clinical picture of Addison’s disease as they do not provide evidence of concentrated urine that arises from the physiological response to low aldosterone levels. Furthermore, while very low glucose might reflect metabolic derangements associated with adrenal insufficiency, it