{"id":850161,"date":"2022-02-05T23:26:54","date_gmt":"2022-02-06T04:26:54","guid":{"rendered":"https:\/\/myendoconsult.com\/learn\/?p=850161"},"modified":"2023-03-16T05:50:38","modified_gmt":"2023-03-16T10:50:38","slug":"sodium-correction-in-hyperglycemia","status":"publish","type":"post","link":"https:\/\/myendoconsult.com\/learn\/sodium-correction-in-hyperglycemia\/","title":{"rendered":"Sodium correction in hyperglycemia"},"content":{"rendered":"<p>A <a href=\"https:\/\/myendoconsult.com\/learn\/endocrinology-calculators\/\">calculator<\/a> for serum sodium correction in the setting of hyperglycemia. In normal physiology, effective osmolarity in the presence of overt hyperglycemia is more clinically relevant than the estimate of serum sodium concentration.<div class='fluentform ff-default fluentform_wrapper_17 ffs_default_wrap'><form data-form_id=\"17\" id=\"fluentform_17\" class=\"frm-fluent-form fluent_form_17 ff-el-form-top ff_form_instance_17_1 ff-form-loading ff_calc_form ffs_default\" data-form_instance=\"ff_form_instance_17_1\" method=\"POST\" ><fieldset  style=\"border: none!important;margin: 0!important;padding: 0!important;background-color: transparent!important;box-shadow: none!important;outline: none!important; min-inline-size: 100%;\">\n                    <legend class=\"ff_screen_reader_title\" style=\"display: block; margin: 0!important;padding: 0!important;height: 0!important;text-indent: -999999px;width: 0!important;overflow:hidden;\">sodium correction calculator (#17)<\/legend>        <div\n                style=\"display: none!important; position: absolute!important; transform: translateX(1000%)!important;\"\n                class=\"ff-el-group ff-hpsf-container\"\n        >\n            <div class=\"ff-el-input--label asterisk-right\">\n                <label for=\"ff_17_item_sf\" aria-label=\"Contact\">\n                    Contact                <\/label>\n            <\/div>\n            <div class=\"ff-el-input--content\">\n                <input type=\"text\"\n                       name=\"item_17__fluent_sf\"\n                       class=\"ff-el-form-control\"\n                       id=\"ff_17_item_sf\"\n                \/>\n            <\/div>\n        <\/div>\n        <input type='hidden' name='__fluent_form_embded_post_id' value='850161' \/><input type=\"hidden\" id=\"_fluentform_17_fluentformnonce\" name=\"_fluentform_17_fluentformnonce\" value=\"7517849c83\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/learn\/wp-json\/wp\/v2\/posts\/850161\" \/><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_serum_sodium' id='label_ff_17_serum_sodium' aria-label=\"Plasma Sodium\">Plasma Sodium<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"serum_sodium\" id=\"ff_17_serum_sodium\" class=\"ff-el-form-control\" placeholder=\"normal range 136-145 (value in mEq\/L)\" data-name=\"serum_sodium\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label ff-el-is-required asterisk-right\"><label for='ff_17_serum_glucose' id='label_ff_17_serum_glucose' aria-label=\"Plasma Glucose\">Plasma Glucose<\/label><\/div><div class='ff-el-input--content'><input type=\"number\" name=\"serum_glucose\" id=\"ff_17_serum_glucose\" class=\"ff-el-form-control\" placeholder=\"normal range 70-105 (value in mg\/dL)\" data-name=\"serum_glucose\" inputmode=\"numeric\" step=\"any\"  aria-invalid=\"false\" aria-required=true><\/div><\/div><div class='ff-el-group'><div class=\"ff-el-input--label asterisk-right\"><label for='ff_17_numeric_field_10' id='label_ff_17_numeric_field_10' aria-label=\"Corrected Serum Sodium\">Corrected Serum Sodium<\/label><\/div><div class='ff-el-input--content'><input type=\"text\" name=\"numeric_field_10\" id=\"ff_17_numeric_field_10\" class=\"ff-el-form-control  ff_has_formula\" data-name=\"numeric_field_10\" data-calculation_formula=\"({input.serum_sodium})+(0.024*({input.serum_glucose}-100))\" readonly=\"1\" min=\"70\" aria-valuemin=\"70\"  aria-invalid=\"false\" aria-required=false><\/div><\/div><div class='ff-el-group ff-text-left ff_submit_btn_wrapper'><button type=\"submit\" class=\"ff-btn ff-btn-submit ff-btn-lg ff_btn_style\"  aria-label=\"Corrected Sodium\">Corrected Sodium<\/button><\/div><\/fieldset><\/form><div id='fluentform_17_errors' class='ff-errors-in-stack ff_form_instance_17_1 ff-form-loading_errors ff_form_instance_17_1_errors'><\/div><\/div>            <script type=\"text\/javascript\">\n                window.fluent_form_ff_form_instance_17_1 = {\"id\":\"17\",\"ajaxUrl\":\"https:\\\/\\\/myendoconsult.com\\\/learn\\\/wp-admin\\\/admin-ajax.php\",\"settings\":{\"layout\":{\"labelPlacement\":\"top\",\"helpMessagePlacement\":\"with_label\",\"errorMessagePlacement\":\"inline\",\"asteriskPlacement\":\"asterisk-right\"},\"restrictions\":{\"denyEmptySubmission\":{\"enabled\":false}}},\"form_instance\":\"ff_form_instance_17_1\",\"form_id_selector\":\"fluentform_17\",\"rules\":{\"serum_sodium\":{\"required\":{\"value\":true,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"}},\"serum_glucose\":{\"required\":{\"value\":true,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"}},\"numeric_field_10\":{\"required\":{\"value\":false,\"message\":\"This field is required\"},\"numeric\":{\"value\":true,\"message\":\"This field must contain numeric value\"},\"min\":{\"value\":\"70\",\"message\":\"Minimum value is \"},\"max\":{\"value\":\"\",\"message\":\"Maximum value is \"}}},\"debounce_time\":300};\n                            <\/script>\n            \n<h2>Formula<\/h2>\n<p><b>Corrected serum sodium<\/b> (Hillier formula) = Measured sodium in mEq\/L + 0.024 x (serum glucose in mg\/dL \u2013 100)\n<h2>Application (Corrected Sodium for serum glucose levels)<\/h2>\n<p>For patients with severe hyperglycemia, it is worth noting that the tonicity of extracellular fluid rises above that of intracellular fluid. This results in a <strong>temporary transcellular shift <\/strong>of glucose and water, in opposite directions (water moves into the extracellular space whilst glucose moves into the intracellular space). Dilution of serum sodium in the extracellular fluid leads to transient lowering of serum sodium.<\/p>\n<h2>Limitations<\/h2>\n<p>Traditionally, two competing papers are cited in the literature when it comes to the right approach for sodium correction in hyperglycemia. The original estimate by Katz in 1973 used a sodium correction factor of <strong>1.6mEq\/L for every 100mg\/dL<\/strong> increase in serum glucose. An external validation study by Hillier et al in 1999 recalibrated the equation using a sodium correction factor of <strong>2.4mEq\/L for every 100mg\/dL<\/strong> increase in serum glucose.<\/p>\n<h2>References<\/h2>\n<ul>\n<li>Katz MA. Hyperglycemia-induced hyponatremia&#8211;calculation of expected serum sodium depression. N Engl J Med. 1973 Oct 18;289(16):843-4. doi: 10.1056\/NEJM197310182891607. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/4763428\/\" target=\"_blank\" rel=\"noopener\">PMID: 4763428.<\/a><\/li>\n<li>Hillier TA, Abbott RD, Barrett EJ. Hyponatremia: evaluating the correction factor for hyperglycemia. Am J Med. 1999 Apr;106(4):399-403. doi: 10.1016\/s0002-9343(99)00055-8. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/10225241\/\" target=\"_blank\" rel=\"noopener\">PMID: 10225241.<\/a><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>A calculator for serum sodium correction in the setting of hyperglycemia. In normal physiology, effective osmolarity in the presence of overt hyperglycemia is more clinically relevant than the estimate of serum sodium concentration. Formula Corrected serum sodium (Hillier formula) = Measured sodium in mEq\/L + 0.024 x (serum glucose in mg\/dL \u2013 100) Application (Corrected [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[100],"tags":[],"class_list":["post-850161","post","type-post","status-publish","format-standard","hentry","category-endocalculator","post-wrapper","thrv_wrapper"],"_links":{"self":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/850161","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/comments?post=850161"}],"version-history":[{"count":64,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/850161\/revisions"}],"predecessor-version":[{"id":4415910,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/850161\/revisions\/4415910"}],"wp:attachment":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media?parent=850161"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/categories?post=850161"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/tags?post=850161"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}