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Key findings pointing toward dehydration include: BUN-to-creatinine ratio above 20:1 (pre-renal azotemia from volume contraction) Serum sodium above 145 mEq/L (hypernatremia from free water deficit) Serum potassium below 3.5 mEq/L (hypokalemia from vomiting or diarrhea) Urine specific gravity above 1.020 on urinalysis A 2021 systematic review in the Annals of Emergency Medicine found that no single clinical sign had sensitivity above 80% for dehydration in adults

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Some very severe but rare ones include the worsening of diabetes-related retinopathy, acute kidney injury, pancreatitis, and medullary thyroid cancer

This matters because sun exposure and poor skin quality can make laxity look more noticeable