The Cardiovascular
ToolsCalculators

Sodium Correction Rate in Hyponatremia and Hypernatremia

Adrogue-Madias estimate of serum sodium change per litre of infusate.

Sodium Correction Rate in Hyponatremia and Hypernatremia
Serum sodium
mEq/L
Body weight
Total body water fraction
Infusate sodium
0.9% saline 154, 3% saline 513, LR 130, 0.45% saline 77, D5W 0
mEq/L
Infusate potassium (if added)
mEq/L
Desired change over 24 h
mEq/L
Complete the fields above to see the result.

When to use

  • Planning an infusate and rate to correct hyponatremia or hypernatremia at a controlled pace.

Formula

Change per litre = (infusate Na + infusate K - serum Na) / (total body water + 1); total body water = weight x fraction.

Pearls and pitfalls

  • Limit correction of chronic hyponatremia to about 6-8 mEq/L per 24 h to avoid osmotic demyelination.
  • The estimate ignores ongoing renal and insensible losses; recheck sodium frequently.

References

  1. Adrogue HJ, Madias NE. N Engl J Med. 2000;342(21):1581-9.