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    Sodium Correction for Hyperglycemia

    Calculates the actual sodium level in patients with hyperglycemia.
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    Pearls/Pitfalls

    Hyperglycemia causes osmotic shifts of water from the intracellular to the extracellular space, causing a relative dilutional hyponatremia. The classic correction factor of 1.6 mEq/L for every 100 mg/dL increase in serum glucose was challenged by a paper by Hillier et al in 1999, and sometimes their factor of 2.4 mEq/L is used.

    mEq/L
    mg/dL

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    Evidence
    Creator Insights

    Advice

    Act on the corrected sodium level, not the measured sodium level.

    Formula

    Corrected Sodium (Katz, 1973) = Measured sodium + 0.016 * (Serum glucose - 100)

    Corrected Sodium (Hillier, 1999) = Measured sodium + 0.024 * (Serum glucose - 100)

    Facts & Figures

    Hillier et. al (1999) evaluated 6 healthy subjects, induced hyperglycemia, and measured actual serum sodium levels, finding a sodium correction factor of 2.4mEq/L to be more accurate than the classically taught 1.6mEq/L correction factor from Katz, 1973.

    Dr. Theresa A. Hillier