MELD-Na

End-stage liver disease — 90-day mortality risk

Total bilirubin

INR

Serum creatinine

Serum sodium (mEq/L)

Dialysis ≥ 2× (or 24 h CVVHD) in the past week

Enter bilirubin, INR, creatinine, and sodium to calculate

Evidence

Original publication

Kim WR, Biggins SW, Kremers WK, et al. Hyponatremia and mortality among patients on the liver-transplant waiting list. Derived the serum-sodium adjustment to MELD adopted by OPTN in 2016 (MELD-Na).

New England Journal of Medicine, 2008

Open source

Validation

Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease. The original MELD, prospectively validated across four independent cohorts of cirrhosis.

Hepatology, 2001

Open source

Guideline

This calculator uses the OPTN/UNOS 2016 MELD-Na formula (labs bounded ≥ 1.0; creatinine ≤ 4.0 or 4.0 if dialysis ≥ 2×/week; sodium bounded 125–137; Na term applied only when MELD > 11; final score 6–40). Newer allocation systems (MELD 3.0) are not implemented.

Last reviewed: 2026-09

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MedScore is an educational and clinical decision-support tool. It does not provide a diagnosis, a treatment, or a drug-dosing recommendation, and it does not replace clinical judgement or local guidelines. Confirm every result against the original source before acting on it. The treating clinician remains responsible for all decisions.