Sodium Change Calculator - Hypertriglyceridemia

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The sodium concentration reported by the laboratory (indirect ISE or flame photometry). Normal range is 135-145 mEq/L.
mEq/L
Serum triglyceride concentration. Pseudohyponatremia is typically significant when triglycerides exceed 1000 mg/dL (11.3 mmol/L).
mg/dL
The simple rule estimates ~1 mEq/L drop per 500 mg/dL of triglycerides. The Waugh plasma-water method estimates the actual water content of plasma from protein and total lipid, then rescales the sodium to the 93% water content assumed by indirect ISE analysers.
Sodium changeMild hyponatremia (if true)
3mEq/L

Estimated artifactual drop in sodium due to elevated triglycerides

Corrected serum sodium131mEq/L
Triglycerides1,500mg/dL
131 mEq/L
Severe hyponatremia<120Moderate hyponatremia120-130Mild hyponatremia130-135Normal135-145Mild hypernatremia145-150Hypernatremia150+

The corrected sodium is 131.0 mEq/L - still below normal even after correction.

  • Elevated triglycerides (1500 mg/dL) are estimated to have lowered the measured sodium by about 3.0 mEq/L.
  • Even after correcting for hypertriglyceridemia, the sodium remains below 135 mEq/L. True hyponatremia co-existing with hypertriglyceridemia must be considered, requiring additional clinical evaluation.
  • Confirm with direct ISE measurement (blood gas analyzer), which measures sodium only in the plasma water phase and is unaffected by lipid content.

Next stepEvaluate for true hyponatremia with serum osmolality, urine osmolality, and urine sodium. Correct the triglycerides as well.

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