Corrected Sodium (Hyperglycaemia)
Corrects serum sodium for the dilutional effect of hyperglycaemia to reveal true sodium status.
Score interpretation
Corrected Na⁺ < 135 mmol/L: True hyponatraemia even accounting for hyperglycaemia.
→ Address both hyperglycaemia and hyponatraemia. Cautious sodium correction. Endocrinology or nephrology review.
Corrected Na⁺ 135–145 mmol/L: Normal sodium once hyperglycaemia is corrected.
→ The apparent hyponatraemia on labs is due to hyperglycaemia (dilutional). Treat hyperglycaemia — sodium will normalise.
Corrected Na⁺ > 145 mmol/L: True hypernatraemia. Volume depletion.
→ Patient is significantly dehydrated. Aggressive fluid replacement required. HHS (hyperosmolar hyperglycaemic state) should be considered.
Interpretation bands for the Corrected Na⁺. Apply clinical judgement and local guidance.
References
- Hillier TA et al. Hyponatraemia: evaluating the correction factor for hyperglycaemia. Am J Med. 1999.
Related
Curated clinical cross-links plus same-class fallbacks.
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Thiopental Sodium · Barbiturate Induction Agent
- Sodium Bicarbonate · Alkalising Agent / Electrolyte
- Sodium Nitroprusside · Vasodilator — Nitric Oxide Donor (IV)
- Dantrolene sodium · Skeletal muscle relaxant (RyR1 inhibitor)
- Sodium Nitroprusside · Vasodilator (Nitric Oxide Donor)
- Diabetic Ketoacidosis (DKA) · JBDS 2013 / Joint British Diabetes Societies; NICE NG17
- Adult Hypoglycaemia (Treated Diabetes) · JBDS-IP (2023): Hospital Management of Hypoglycaemia
- Adrenal Crisis · Society for Endocrinology Emergency Guidance (2024)
- Type 2 Diabetes Management · NICE NG28 2022
- Hyperthyroidism Management · BTA / ETA 2018
- Adrenal Insufficiency · Society of Endocrinology / ESE 2016
Featured in these MRCEM clinical pathways
The Corrected Na⁺ is covered in detail — with RCEM/NICE evidence base, indications and pitfalls — in the following exam-focused pathways on our sister siteReviseMRCEM.
MRCEM Primary / Intermediate / OSCE candidates: each pathway includes exam-style questions, RCEM/NICE citations, and FAQ summaries.
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.