MELD-Na Score
MELD incorporating serum sodium. Better predictor of 3-month transplant waitlist mortality than MELD alone.
How to use & interpret
MELD-Na adds serum sodium to the standard MELD (bilirubin, INR, creatinine) because hyponatraemia independently predicts worse outcomes in cirrhosis, improving the estimate of 90-day mortality. It is used for liver transplant prioritisation and to gauge prognosis.
Higher scores indicate higher mortality and greater transplant priority. As with MELD, it is intended for chronic liver disease rather than acute liver failure.
Score interpretation
MELD-Na ≤9: Low 3-month waitlist mortality.
→ Continue hepatology follow-up.
MELD-Na 10–19: Moderate risk.
→ Hepatology review. Address hyponatraemia if present.
MELD-Na 20–29: High risk.
→ Transplant listing consideration. Manage sodium carefully (avoid rapid correction).
MELD-Na ≥30: Very high 3-month waitlist mortality.
→ Priority transplant evaluation. ITU/HDU support as required.
Interpretation bands for the MELD-Na. Apply clinical judgement and local guidance.
Frequently asked questions
Why add sodium to MELD?
Low serum sodium is a marker of advanced portal hypertension and is associated with higher waiting-list mortality, so including it improves risk prediction for many patients.
References
- Kim WR et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. N Engl J Med. 2008.
Related
Curated clinical cross-links plus same-class fallbacks.
- Sodium Chloride 3% (Hypertonic Saline) · Hypertonic Electrolyte Solution — ICP/Hyponatraemia Management
- Sodium Zirconium Cyclosilicate · Heart Failure
- Sodium Hyaluronate 0.1% Eye Drops (Hylo-Forte) · Ocular lubricant (viscous eye drop — dry eye disease)
- Thiopental Sodium · Barbiturate Induction Agent
- Sodium Bicarbonate · Alkalising Agent / Electrolyte
- Sodium Nitroprusside · Vasodilator — Nitric Oxide Donor (IV)
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.