Free Water Deficit Hypernatremia

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Free Water Deficit Calculator

Estimated Fluid Deficit:

Disclaimer: This tool is for educational purposes only and does not replace professional medical advice. Always consult clinical context.

Free Water Deficit in Hypernatremia: A Clinical Overview

Accurate estimation of free water deficit (FWD) in hypernatremia is critical for guiding safe and effective fluid replacement. Hypernatremia, commonly defined as a serum sodium level >145 mEq/L, reflects a state of relative free water deficit within the body. Without careful replacement, hypernatremia can cause severe neurologic sequelae due to osmotic shifts and potential cerebral shrinkage. This article provides an overview of the formula used to calculate free water deficit, relevant considerations for different patient populations, and key insights from foundational literature.


Hypernatremia arises when total body water losses outpace total body solute, resulting in a net deficit of free water relative to sodium. The free water deficit calculation offers a systematic method to estimate the volume of hypotonic fluid necessary to restore serum sodium to a target level, typically around 140 mEq/L. Treatment goals include gradual correction to minimize the risk of neurologic complications such as cerebral edema, which can arise if sodium is lowered too quickly.


Formula for Free Water Deficit
Free water deficit can be approximated by the following equation:

Typical total body water fractions include:

  • Adult male: 0.6 (60%)
  • Adult female: 0.5 (50%)
  • Elderly male: 0.5 (50%)
  • Elderly female: 0.45 (45%)
  • Child: 0.6 (60%)
About the Author MyEndoConsult

The MyEndoconsult Team. A group of physicians dedicated to endocrinology and internal medicine education.

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