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Sodium Correction Rate Calculator for Hypo- and Hypernatremia

Table of contents

What's the rate of sodium correction formula?How do I use the calculator to calculate the sodium correction rate?FAQs

The sodium correction rate calculator uses the patient's weight, serum sodium concentration, the aimed increase of serum sodium, and the chosen fluid's parameters to find the serum sodium change per liter and the rate of the sodium replacement fluid flow.

Come along to learn:

  • What sodium correction formula is used by our calculator;
  • How to go about calculating the sodium correction rate;
  • What is the recommended maximum rate of sodium replacement per day to treat hyponatremia safely; and
  • Much more.

You'll also probably find our water deficit, sodium deficit, sodium correction for hyperglycemia, and fractional excretion of sodium (FENa) calculators useful.

We try our best to make our Omni Calculators as precise and reliable as possible. However, this tool can never replace a professional doctor's assessment. All information on this website is for informational purposes only and is not intended as a substitute for medical consultation. Always consult your healthcare provider if you are unwell.

What's the rate of sodium correction formula?

The sodium correction rate calculator uses the Adrogue-Madias formula, as it is the one most widely used sodium correction formula in the prediction of serum sodium change:

change in serum sodium = (fluid_sodium - serum_sodium) / (TBW + 1)

where:

  • fluid_sodium is the concentration of sodium in the fluid you're planning to use. The values provided here are based on this table of the composition of commonly used crystalloids by the National Institute for Health and Care Excellence (NICE).
  • serum_Na is the measured concentration of sodium in the blood serum.
  • TBW is the total body water. We calculate this by multiplying the patient's weight by the age/sex coordinate, which equals 60% for children and adult males, 50% for adult females and elderly males, and 45% for elderly females. See the total body water calculator.

Then, to calculate the sodium correction rate, we use the inverse of the previous calculation:

correction flow rate = 1000 × aimed_change × (TBW + 1) / (fluid_sodium - serum_sodium),

where:

  • aimed_change is the aimed serum sodium change per hour. As there is a risk of overcorrection.

Keep in mind that rapid sodium correction may lead to cerebral edema or the development of osmotic demyelination, which may, in turn, result in brain damage or death.

Experts recommend that the sodium correction should not exceed 8 mmol/L/day. Remaining within this daily range, the initial correction rate in patients with severe symptoms can be 1 - 2 mEq/L/hr for several hours.

You should always check the results and the current guidelines with another healthcare provider, as the sodium replacement rate calculator cannot replace clinical judgment and medical assessment.

How do I use the calculator to calculate the sodium correction rate?

  1. Choose the patient's age/sex group from the five options given in the first line: child, adult female, adult male, elderly female, and elderly male.

  2. Type in the patient's weight in the preferred unit.

  3. Enter the measured serum sodium level. If your results are in mmol/L, type in these values – in the case of sodium, they are equal to those in mEq/L.

  4. Choose the kind of sodium replacement fluid you're planning to use.

  5. The predicted serum sodium change per liter of administered replacement fluid is given in the second to last field in milliequivalents per liter (mEq/L), which is equal to millimoles per liter (mmol/L).

  6. The calculated sodium correction rate is presented in the last field in milliliters per hour (ml/h).

FAQs

Can rapid sodium correction lead to complications in hypernatremia?

Rapidly correcting high serum sodium levels can lead to severe complications, such as cerebral edema. This occurs due to the rapid movement of water from the bloodstream into cells, including brain cells, causing them to swell.

How do I calculate total body weight for sodium correction rate in hyponatremia?

If you're trying to determine the sodium correction rate in hyponatremia, and you want to calculate the total body weight to use it in for the formula, you can follow these steps:

  1. Take the weight of the patient in kg.
  2. Multiply the weight by the percentage of body water according to the table below:

Age

Male

Female

Child

0.6

0.6

Adult

0.6

0.5

Elderly

0.5

0.45

That's it. You now have the total body weight for sodium correction rate in hyponatremia.

What is the formula for the correction of sodium in hyponatremia?

To find the change in serum sodium, use:

Change in serum sodium = (Fluid sodium - Serum sodium) / (TBW + 1)

where:

  • Fluid sodium is the sodium concentration in the fluid;
  • Serum sodium refers to the serum sodium concentration; and
  • TBW is the total body water.

Then, determine the correction flow rate with the following:

Correction flow rate = 1000 × Aimed change × (TBW + 1) / (Fluid sodium - Serum sodium)

where:

  • Aimed change is the desired hourly serum sodium change, considering overcorrection risk.

How do I correct sodium at 120 mEq/L in a patient?

To correct a sodium level of 120 mEq/L in a patient:

  • Determine the patient's age, sex, and weight;
  • Choose the appropriate sodium replacement fluid and rate of sodium correction; and
  • Apply the Adrogue-Madias formula.

For example, for an adult male (70 kg) using a 2% saline solution at a rate of 0.5 mEq/L/h, sodium correction would be 97 mL/h.

Sodium correction should only be performed by medical professionals in accordance with the patient's unique clinical circumstances.

Always double-check the calculations. Remember, this tool cannot replace clinical judgment and management guidelines and shouldn't be used independently to make clinical decisions.

Many experts recommend the sodium correction should not exceed 8 mmol/L/day. The initial correction rate in patients with severe symptoms can be 1-2 mEq/L/hr for several hours while remaining in the daily recommended ranges. Rapid sodium correction may lead to cerebral edema or osmotic demyelination, which may result in brain damage or death.

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