This corrected sodium calculator corrects the results of serum sodium (Na+) tests, which can be skewed in hyperglycemia. The patient’s serum sodium and blood glucose levels are required for the calculation. Continue reading to learn how to compute corrected sodium and the sodium correction formula. Water travels from the intracellular to the extracellular area to dilute excess glucose with hyperglycemia (high blood sugar levels). This change can cause a drop in serum sodium levels.
In hospitalized patients, we can relate hyponatremia and hypernatremia to an increased risk of death. We can also associate hyponatremia with a grim prognosis in individuals with chronic kidney disease, heart failure, liver illness, or intracerebral hemorrhage. Previous researchers have shown that changed mental status on admission, pneumonia, older age, stroke, myocardial infarction, sepsis, renal impairment, hyperkalemia, and decreased blood pressure are all predictive indicators for mortality in severe hyperglycemic patients.
We could ignore patients with hyponatremia during severe hyperglycemia since hyperglycemia can lower sodium content. The corrected blood sodium level for severe hyperglycemia should be a predictive factor in predicting clinical outcomes in severe hyperglycemic patients, according to some hypotheses. However, we can measure serum sodium and correct sodium levels to know how it affects patients with acute hyperglycemia in the emergency room (ED).
Corrected Sodium Calculator Formula
Dr. Teresa A. Hillier devised the equation, which she published in the article Hyponatremia: Evaluating the Correction Factor for Hyperglycemia in 1998.
Corrected sodium level= serum sodium +0.024 x (serum glucose-100)
You’ll find an older version of the revised, corrected sodium formula in the calculator’s advanced mode. Hyperglycemia-Induced Hyponatremia Calculation of Expected Serum Sodium Depression is an equation created in 1973 by Dr. Murray A. Katz.
Corrected sodium level= serum sodium +0.016 x (serum glucose-100)
However, to use our corrected sodium calculator follow the steps below:
- Enter the sodium level in the patient’s blood (Na+). The values in mmol/L are identical to the values in mEq/L if the test results are in mmol/L.
- Fill in the preferred unit for the blood glucose level. By clicking on the unit symbol, you can change it. Alternatively, you can use our glucose unit converter.
- They display the coreccted sodium value in the last field.
- Click the advanced mode button to see what the result would be if you use an older version of the corrected sodium equation.
Use our corrected sodium rate calculator if you want to correct the patient’s hypo- or hypernatremia.
Sodium Correction for Hyperglycemia
In patients with hyperglycemia, pre-existing high glucose levels may affect the serum sodium (Na) result. If there is no change in total body water in excessively high blood glucose levels, the observed low sodium levels are most likely because of the hyponatremic reaction and should not be confused with established hyponatremia.
Before interpreting sodium levels, make sure you do:
- (Katz, 1973) Sodium Correction = Measured sodium in mEq/L + 0.016 x (Serum glucose in mg/dL – 100)
Hillier et al. changed Katz’s original formula in 1999, finding the necessity for a higher correction factor, particularly when serum glucose levels exceed 400 mg/dL.
- Measured sodium in mEq/L + 0.024 x (Serum glucose in mg/dL – 100) = Sodium Correction (Hillier, 1999).
The three processes that make up the physiological mechanism that causes apparent hyponatremia are:
- Extracellular fluid osmolality rises above that of intracellular fluid when glucose levels rise abnormally, causing glucose to enter the cell and displacing water back into the extracellular space.
- As a result, the cell loss of cellular water, and the serum Na content decreases in proportion to the dilution of extracellular fluid.
- To reflect the true natremia situation in the body, we computed serum sodium correction using a correction factor of 2.4mEq/L or 1.6mEq/L for every 100 mg/dL increase in plasma glucose levels above normal.
When serum glucose levels return to normal (either through natural insulin mechanisms or through the administration of external insulin), serum sodium levels return to normal as well, eliminating the need for sodium correction infusate, as would have been the case if the hyponatremia was permanent and not just temporary.
Corrected Sodium Levels and Symptoms
When the body loses too much water or gains too much sodium, hypernatremia develops. As a result, there is insufficient body water in relation to total body sodium. Changes in water consumption or loss might affect the sodium concentration in the blood. A variety of factors can generate changes in fluid, including Changes in urine concentration, which are accompanied by substantial changes in thirst.
Thirst and urine concentrations are triggered in healthy humans by brain receptors that identify the need for fluid or sodium corrected. Increased water intake or variations in the amount of sodium discharged in the urine are common outcomes. We can quickly correct hypernatremia with this method.
However, Excessive thirst is the most common symptom of hypernatremia. Lethargy, or excessive exhaustion and lack of energy, and sometimes disorientation are other symptoms. Muscle twitching or spasms may occur in advanced cases. This is because sodium is necessary for the proper functioning of muscles and nerves. Seizures and coma are possible side effects of high sodium levels. Severe symptoms are uncommon, occurring primarily when salt levels in the blood plasma rise rapidly and dramatically.
Sodium Correction for Glucose
The blood sodium concentration drops by 1.6 mEq/l for every 100 mg/dl increase in glucose concentration due to water transfers from the intracellular to the extracellular compartment, according to a rule of thumb in clinical medicine. This correction factor was developed based on theoretical concerns and has not been thoroughly tested. When employing the conventional change factor, experimental research in healthy volunteers observed considerably higher declines in sodium concentration than expected, especially when glucose concentrations were above 400 mg/dl.
A correction factor of 2.4 mEq/l per 100 mg/dl rise in glucose concentration has been proposed as a better overall estimate of the relationship between blood sodium and glucose concentrations. Considering current efforts to align the sodium content in the dialysis fluid with that of the serum during HD treatment, precise knowledge of this correction factor for hemodialysis (HD) patients is becoming increasingly crucial. Sodium loading and associated thirst increase interdialytic weight gain, and hypertension can occur if the sodium concentration in the dialysis fluid is higher than the sodium content in the blood.
In conclusion, the study showed a 1.5 mEq/l reduction in sodium concentration per 100 mg/dl increase in glucose concentration, which is slightly lower than the 1.6 mEq/l commonly utilized in clinical practice. However, our findings support the use of the 1.6 mEq/l correction factor in clinical practice.
If the adjusted sodium concentration is normal despite a very high serum glucose concentration, the patient is drinking enough water or the onset of hyperglycemia was very sudden. Our corrected sodium calculator, on the other hand, will assist in correcting the results of serum sodium (Na+) tests, which can be skewed in hyperglycemia, hyponatremia, and hypernatremia.
FAQS about Corrected Sodium Calculator
How long does it take to recover from a sodium deficiency?
When low sodium is minor or connected to your diet, it is usually asymptomatic (does not cause symptoms). The consequences of a low-salt diet can take weeks or months to manifest, but they can be reversed with just one day of normal salt consumption.
Is it necessary to utilize corrected sodium to calculate the anion gap?
Should we calculate the anion gap using the corrected sodium? No! The anion gap in the extracellular fluid indicates the equilibrium of positively and negatively charged electrolytes. Because glucose is electrically neutral, it has no effect on the anion gap.
What is the quickest approach to correct sodium levels?
The rate of corrected sodium in patients with severe symptomatic hyponatremia should be 6 to 12 mEq per L in the first 24 hours and 18 mEq per L or less in the next 48 hours. To treat severe hyponatremia, a bolus of 100 to 150 mL hypertonic 3 percent saline might be given.
Why is it necessary to treat hyperglycemia with sodium?
As their glucose levels rose, all of the subjects’ serum sodium levels dropped. The average slope was 2.4 (0.3) mEq per L sodium per 100 mg per dL glucose when plotted on a simple straight line regression. This correction factor is much higher than the standard correction factor.
How does Hyperlipidemia Causes Hyponatremia?
There is a rise in the bulk of the nonaqueous components of serum and a concurrent decrease in the proportion of serum made up of water in situations of hyperproteinemia or hyperlipidemia. Because the flame photometry method detects sodium concentration in the entire plasma, pseudo hyponatremia develops.