Sodium Correction Rate Calculator

Sodium Correction Rate Calculator

Sodium Correction Rate Calculator

Estimates IV fluid type, rate, and volume for planned sodium correction in adult hyponatraemia or hypernatraemia using the Adrogué–Madias equation. This is a teaching and decision-support tool only; electrolyte emergencies require clinician review and frequent serum sodium monitoring.

Patient and clinical inputs

Usually an initial partial target, not full normalisation.
Used to check safety and calculate a rate.

Infusate

Results

Enter values and click Calculate.

Fluid comparison table

Estimated effect of 1 L of common fluids using the same patient inputs. Negative values lower serum sodium; positive values raise serum sodium.

Formula and clinical notes

Adrogué–Madias estimate:

Change in serum Na⁺ per 1 L = ((infusate Na⁺ + infusate K⁺) − serum Na⁺) / (TBW + 1)

TBW = weight × TBW factor

  • This formula estimates the effect of 1 litre in a simplified closed system. It does not account for ongoing urine, gastrointestinal, insensible, or sodium/potassium losses.
  • Use repeated sodium checks and reassess therapy frequently. In actively correcting patients, checks every 2–4 hours are commonly used in practice, with local protocol and senior review.
  • For severe symptomatic hyponatraemia, many protocols use hypertonic saline boluses to achieve a small early rise, then stop or slow correction.
  • For hypovolaemic hypernatraemia with shock or severe volume depletion, restore intravascular volume first with isotonic crystalloid, then correct free-water deficit with hypotonic fluid.

References

  1. Spasovski G, Vanholder R, Allolio B, et al. Clinical practice guideline on diagnosis and treatment of hyponatraemia. European Journal of Endocrinology. 2014.
  2. Verbalis JG, Goldsmith SR, Greenberg A, et al. Diagnosis, evaluation, and treatment of hyponatremia: expert panel recommendations. American Journal of Medicine. 2013.
  3. Sterns RH. Treatment Guidelines for Hyponatremia: Stay the Course. Clinical Journal of the American Society of Nephrology. 2024.
  4. Adrogué HJ, Madias NE. Aiding fluid prescription for the dysnatremias. Intensive Care Medicine. 1997.
  5. Yun G, Kim S. Evaluation and management of hypernatremia in adults: clinical perspectives. Electrolyte & Blood Pressure. 2022.
  6. Sonani B, Naganathan S, Al-Dhahir MA. Hypernatremia. StatPearls/NCBI Bookshelf. Updated 2023.

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