Renal Endocrinology Emergency Medicine Standard — correction factor 1.6 mmol/L per 5.5 mmol/L glucose above 5.5

Sodium Correction for Hyperglycaemia

Calculates the corrected (true) serum sodium in hyperglycaemic states (DKA, HHS). Hyperglycaemia causes osmotic dilution of sodium — the corrected value guides fluid resuscitation.

Used in: Diabetes & DKA Hyponatraemia

Score interpretation

Corrected Na⁺ Low — True Hyponatraemia 0–134

Corrected sodium < 135 mmol/L: True hyponatraemia even after glucose correction.

→ Investigate hyponatraemia cause. In HHS/DKA: cautious fluid resuscitation with 0.9% NaCl. Avoid rapid sodium correction. Measure every 2h.

Corrected Na⁺ Normal 135–145

Corrected sodium 135–145 mmol/L: Normonatraemia when glucose effect corrected.

→ Pseudohyponatraemia confirmed. Treat underlying hyperglycaemia. As glucose falls, sodium will rise — avoid over-correction.

Corrected Na⁺ Mildly Elevated 146–154

Corrected sodium 146–154 mmol/L: Mild true hypernatraemia.

→ In HHS: use 0.45% NaCl after initial 0.9% NaCl resuscitation. Monitor closely. Target: correct glucose and sodium together gradually.

Corrected Na⁺ Significantly Elevated ≥ 155

Corrected sodium > 155 mmol/L: Significant hypernatraemia — severe dehydration.

→ Aggressive fluid resuscitation. HDU. Aim to reduce corrected Na⁺ no faster than 10–12 mmol/L/24h. Endocrinology/nephrology review in complex cases.

Interpretation bands for the Corrected Sodium. Apply clinical judgement and local guidance.

References

Hillier TA, et al. Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med. 1999;106(4):399–403.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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