Calculators & Tools

Serum Osmolality Calculator

2Na + Glucose/18 + BUN/2.8

1 What is the Serum Osmolality Calculator?

The Serum Osmolality Calculator estimates a patient's calculated serum osmolality from three routine labs — sodium, glucose, and blood urea nitrogen (BUN) — using the standard calculated-osmolality formula. It also supports an optional osmolar gap calculation when a lab-measured osmolality is available, which helps flag unmeasured osmotically active substances such as toxic alcohols. The tool is built around a normal reference range of 270–295 mOsm/kg and provides bedside interpretation for hypo-osmolar and hyperosmolar results.

2 When to use it

  • Evaluating suspected hyponatraemia, SIADH, or water intoxication
  • Assessing suspected dehydration, hypernatraemia, or hyperglycaemic states such as DKA/HHS
  • Screening for an osmolar gap when toxic alcohol ingestion (methanol, ethylene glycol, isopropanol) is suspected
  • Working up altered mental status or an unexplained acid-base/electrolyte derangement
  • Judging how quickly a dysnatraemia can safely be corrected

3 Formula & method

Calculated osmolality = 2 × Na + Glucose / 18 + BUN / 2.8 (mOsm/kg), using sodium in mEq/L and glucose/BUN in mg/dL. Normal range is 270–295 mOsm/kg. When a measured osmolality is entered, the app also calculates the osmolar gap (measured − calculated); a gap greater than 10 raises suspicion for a toxic alcohol (methanol, ethylene glycol, isopropanol). The app's reference notes specify using total (uncorrected) sodium in the formula.
  • Fluid and Electrolyte Formulae
  • Goldfrank's Toxicologic Emergencies, 11th ed.

4 Frequently asked questions

What formula does the calculator use for serum osmolality?

It uses the standard calculated-osmolality equation: 2 × Na + Glucose/18 + BUN/2.8, with sodium in mEq/L and glucose/BUN in mg/dL.

What is a normal serum osmolality?

The app defines normal as 270–295 mOsm/kg; values below this range are flagged hypo-osmolar and values above are flagged hyperosmolar.

What does the osmolar gap tell me?

It is the difference between a lab-measured osmolality and the calculated value; the tool flags a gap over 10 mOsm/kg as suspicious for an unmeasured osmole such as a toxic alcohol.

Should I use corrected or total sodium in this calculator?

The app's reference notes specify using total (uncorrected) sodium in the formula, not a sodium value corrected for glucose.

What causes a hyperosmolar result in the app's interpretation?

The app lists dehydration, hypernatraemia, hyperglycaemia (DKA/HHS), and mannitol therapy as causes, and advises correcting slowly to avoid cerebral oedema.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.