Corrected Sodium Calculator

Calculate corrected sodium level to account for hyperglycemia-induced pseudohyponatremia, essential in diabetic ketoacidosis and hyperglycemic states.

Corrected Sodium = Measured Sodium + 0.016 × (Glucose - 100) Where: • Measured Sodium = Serum sodium (mEq/L) • Glucose = Serum glucose (mg/dL) • 0.016 = Correction factor (most commonly used) • 100 = Baseline glucose level (mg/dL) Correction Factor: • For Glucose ≤ 400 mg/dL: use 0.016 • Alternative: 1.6 mEq/L per 100 mg/dL glucose increase • For Glucose > 400 mg/dL: some sources use 0.024 Interpretation: • Normal: 135-145 mEq/L • Hyponatremia: < 135 mEq/L • Hypernatremia: > 145 mEq/L
Example: Patient with diabetic ketoacidosis (DKA) Measured Sodium: 130 mEq/L Glucose: 400 mg/dL Calculation: Correction = 0.016 × (400 - 100) Correction = 0.016 × 300 Correction = 4.8 mEq/L Corrected Sodium = 130 + 4.8 = 134.8 mEq/L Interpretation: • Measured Na: 130 mEq/L (appears low - pseudohyponatremia) • Corrected Na: 134.8 mEq/L (borderline normal) • Correction Applied: +4.8 mEq/L • Status: Mild Hyponatremia Clinical Significance: The measured sodium is artificially low due to hyperglycemia-induced water shift. The corrected value reveals true sodium status, guiding appropriate fluid management in DKA treatment.

Why do we need to correct sodium for glucose?

Hyperglycemia causes osmotic shift of water from intracellular to extracellular space, diluting serum sodium and causing pseudohyponatremia. The measured sodium is artificially low. Corrected sodium calculation accounts for this dilutional effect, revealing true sodium status. For every 100 mg/dL glucose rises above 100, sodium decreases by approximately 1.6 mEq/L. This correction is crucial for proper diagnosis and treatment of electrolyte disorders in diabetic emergencies.

What is the formula for corrected sodium?

Corrected Sodium = Measured Sodium + 0.016 * (Glucose - 100). Alternative formulas exist: some use factor 0.024 for glucose >400 mg/dL, or simplified 1.6 mEq/L per 100 mg/dL glucose increase. The 0.016 factor is most commonly used. Example: Measured Na 130, Glucose 400: Corrected Na = 130 + 0.016 * (400-100) = 130 + 4.8 = 134.8 mEq/L. Always use corrected sodium for clinical decisions in hyperglycemia.

When should I use the corrected sodium calculation?

Use corrected sodium when: Glucose >150 mg/dL (especially >200), evaluating hyponatremia in diabetic ketoacidosis (DKA) or hyperosmolar hyperglycemic state (HHS), assessing true sodium status before treatment, calculating free water deficit. Don't use for normal glucose levels. In DKA, corrected sodium typically normal or high despite low measured sodium; true hyponatremia in DKA suggests severe volume depletion or other pathology.

What is normal corrected sodium range?

Normal serum sodium is 135-145 mEq/L (some labs use 136-145). Hyponatremia: <135 mEq/L (mild 130-134, moderate 125-129, severe <125). Hypernatremia: >145 mEq/L (mild 145-150, moderate 150-160, severe >160). Symptoms depend on acuity and severity. Acute changes more dangerous than chronic. Always interpret corrected sodium, not measured sodium, when glucose elevated. Treat based on corrected value and clinical context.

How does corrected sodium guide treatment in DKA?

In DKA, measured sodium often low (pseudohyponatremia), but corrected sodium reveals true status. If corrected sodium normal/high: expect it to rise further as glucose falls during treatment; give hypotonic saline or NS carefully. If corrected sodium truly low: indicates severe volume depletion; aggressive NS resuscitation needed. Monitor corrected sodium during DKA treatment - should stay stable or rise slightly as glucose normalizes. Prevents inappropriate treatment of pseudohyponatremia.

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