Curated insights • How it Works • Practical Pearls • Evidence Base
This calculation identifies "translational hyponatremia"—a predictable drop in sodium caused by osmotic shifts rather than a true sodium deficiency.
Glucose is an effective osmole. When serum glucose rises, it increases extracellular tonicity, creating an osmotic gradient that draws water from the intracellular to the extracellular space. This influx of water dilutes the serum sodium concentration.
Corrected Na = Measured Na + [1.6 × (Glucose - 100) / 100]
If the corrected sodium is high (> 145 mEq/L) in a patient with HHS, it indicates severe total body water depletion and a high risk of cardiovascular collapse if not hydrated carefully.
The corrected sodium provides a better correlate for the patient’s mental status. If a patient is comatose with a measured sodium of 128 but a corrected sodium of 142, the altered mental status is likely due to hyperosmolarity or acidosis rather than hyponatremic encephalopathy.
Hyperglycemia-induced hyponatremia—calculation of expected serum sodium depression.
Hyponatremia and hyperglucosemia: a reevaluation of the correction factor.
A nephrologist and professor of medicine whose 1973 letter to the NEJM remains one of the most cited clinical rules in electrolyte management. His work simplified the bedside approach to "pseudohyponatremia" (a term now largely replaced by translational hyponatremia in this context).
Curated insights • How it Works • Practical Pearls • Evidence Base
This calculation identifies "translational hyponatremia"—a predictable drop in sodium caused by osmotic shifts rather than a true sodium deficiency.
Glucose is an effective osmole. When serum glucose rises, it increases extracellular tonicity, creating an osmotic gradient that draws water from the intracellular to the extracellular space. This influx of water dilutes the serum sodium concentration.
Corrected Na = Measured Na + [1.6 × (Glucose - 100) / 100]
If the corrected sodium is high (> 145 mEq/L) in a patient with HHS, it indicates severe total body water depletion and a high risk of cardiovascular collapse if not hydrated carefully.
The corrected sodium provides a better correlate for the patient’s mental status. If a patient is comatose with a measured sodium of 128 but a corrected sodium of 142, the altered mental status is likely due to hyperosmolarity or acidosis rather than hyponatremic encephalopathy.
Hyperglycemia-induced hyponatremia—calculation of expected serum sodium depression.
Hyponatremia and hyperglucosemia: a reevaluation of the correction factor.
A nephrologist and professor of medicine whose 1973 letter to the NEJM remains one of the most cited clinical rules in electrolyte management. His work simplified the bedside approach to "pseudohyponatremia" (a term now largely replaced by translational hyponatremia in this context).
