Adrogue HJ, Madias NE
A new formula that facilitates the treatment of hyponatremia
and hypernatremia
Am Soc Nephrol
J Am Soc Nephrol (abstract)
(Sep) 7:1346 1996
The formulas generally offered to facilitate the treatment of hyponatremia
and hypernatremia are
certainly laborious with separate formulas usually given for sodium and water
deficits. Once the
relevant deficiency is estimated, a fluid and volume must be chosen which
will replace the
calculated deficiency. Adrogue and Madias offer a more efficient
alternative with which to treat
any "dysnatremia". They propose that the expected change in the serum sodium
(d{Na}s) following the
infusion of 1 liter of any solution is given by the formula:
d{Na}s = ( {Na}inf - {Na}s) / (TBW +1)
Where {Na}inf and {Na}s are the sodium concentrations of the infusate and
serum, respectively, and
TBW is the total body water.
Comment: This formula would indeed appear to be a more succinct
approach to the mathematics
of sodium abnormalities than is otherwise clinically available. However, the
abstract contains no
discussion of the author's clinical experience with its accuracy or precision
in clinical
applications. The utility of this novel formula will be better known when
this data is available.
Greg Cowell, M.D., University of Illinois at Chicago
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Am Soc Nephrol
Sodium/water transport :
Hypernatremia
Sodium/water transport :
Hyponatrenia