Health calculators

MELD Na Calculator

Updated Jul 12, 2026 By Jehan Wadia
Clinical Inputs
Dialysis Status

Dialysis ≥ 2× in the past week, OR for ≥ 24 hours in the past week.

Values > 4.0 mg/dL are auto-capped at 4.0. If on dialysis, creatinine is auto-set to 4.0.

Values < 1.0 mg/dL are automatically floored at 1.0.

Values < 1.0 are automatically floored at 1.0.

Values < 125 mEq/L are floored at 125. Values > 137 mEq/L are capped at 137.

Note: MELD Na is validated for patients ≥ 12 years of age. For patients under 12, consider using the PELD calculator instead.
Results
MELD(i) Score
21
Base score before sodium adjustment.
MELD Na Score
25
3-Month Mortality
~19.6%
MELD Na 20–29
Sodium adjustment was applied to the final score.
3-Month Mortality Risk Band
Moderate — ~19.6% (MELD Na 20–29)
MELD Na is used by UNOS/OPTN (post-January 2016) to prioritize liver transplant candidates. Higher scores indicate greater 90-day mortality risk without transplant.
Step-by-Step Solution
Score Composition (points)

Introduction

The MELD Na (Model for End-Stage Liver Disease with Sodium) score helps doctors measure how sick a patient's liver is. It uses four lab values — creatinine, bilirubin, INR, and sodium — along with dialysis status to produce a score between 6 and 40. A higher score means the liver disease is more severe and the risk of death within 90 days is greater.

Since January 2016, UNOS (the United Network for Organ Sharing) has used the MELD Na score to decide which patients on the liver transplant waiting list should receive an organ first. The original MELD score did not include sodium. Adding sodium made the score better at predicting short-term mortality, especially in patients with low sodium levels caused by advanced liver disease.

This calculator lets you enter lab values, choose your preferred units, and get results right away. It shows your MELD(i) base score, the final MELD Na score, and an estimated 3-month mortality risk. A full step-by-step breakdown of the math and a chart of each component's contribution are also provided so you can see exactly how the score is calculated.

How to Use Our MELD Na Calculator

Enter your liver lab values below to get a MELD Na score, a MELD(i) score, and a 3-month mortality estimate. You need five pieces of information from a recent blood test or medical record.

Dialysis Status: Choose "Yes" if the patient had dialysis two or more times in the past week, or had CVVHD for 24 hours or more in the past week. Choose "No" if neither applies. Picking "Yes" locks creatinine at 4.0 mg/dL.

Creatinine: Type the creatinine level from the blood test. You can switch between mg/dL and µmol/L using the unit buttons. Values above 4.0 mg/dL are capped at 4.0, and values below 1.0 are raised to 1.0. For a deeper look at kidney function, you may also want to use our Creatinine Clearance Calculator or GFR Calculator.

Total Bilirubin: Type the total bilirubin level. You can switch between mg/dL and µmol/L. Values below 1.0 mg/dL are raised to 1.0.

INR: Type the INR value from the coagulation panel. Values below 1.0 are raised to 1.0.

Sodium (Na): Type the sodium level in mEq/L. Values below 125 are raised to 125, and values above 137 are lowered to 137. If you need to assess overall electrolyte balance, our Serum Osmolality Calculator and Anion Gap Calculator can also be helpful.

Press Calculate to see your results. Press Reset to clear all fields and start over. The calculator updates automatically as you type or change any input.

What Is the MELD Na Score?

The MELD Na score stands for Model for End-Stage Liver Disease with Sodium. It is a number that doctors use to measure how sick a person's liver is. The score ranges from 6 to 40. A higher score means the liver disease is more serious.

Why Is the MELD Na Score Important?

Since January 2016, the United Network for Organ Sharing (UNOS) has used MELD Na to decide who gets a liver transplant first. Patients with higher scores are in greater danger, so they move higher on the transplant waiting list. The score helps predict the chance of dying within 90 days without a transplant.

How Is MELD Na Calculated?

The MELD Na score uses four lab values from a simple blood test:

  • Creatinine — shows how well the kidneys are working. For additional renal assessment, see our BUN Creatinine Ratio Calculator.
  • Bilirubin — shows how well the liver clears waste from the blood.
  • INR (International Normalized Ratio) — shows how well the blood can clot.
  • Sodium (Na) — a salt in the blood that often drops when liver disease gets worse.

The calculator also asks if the patient is on dialysis. If the patient had dialysis two or more times in the past week, creatinine is automatically set to 4.0 mg/dL because kidney function is already severely affected.

What Does My Score Mean?

The score gives an estimate of 3-month mortality risk — the chance of dying within 90 days:

  • MELD Na ≤ 9: About 1.9% risk. This is low.
  • MELD Na 10–19: About 6% risk. This is mild.
  • MELD Na 20–29: About 19.6% risk. This is moderate.
  • MELD Na 30–39: About 52.6% risk. This is high.
  • MELD Na ≥ 40: About 71.3% risk. This is very high.

How Does Sodium Affect the Score?

Low sodium in the blood is common in people with advanced liver disease. It is a sign that the body is holding too much water. Studies showed that adding sodium to the old MELD formula made the score better at predicting outcomes. The sodium adjustment only applies when the base MELD score (called MELD(i)) is greater than 11. Sodium values are clamped between 125 and 137 mEq/L for the calculation.

Important Limits

The MELD Na score is meant for adults and children 12 years and older. For children under 12, doctors use a different score called PELD (Pediatric End-Stage Liver Disease). This calculator should not replace advice from a doctor. Always talk to a hepatologist or transplant team about your results. Clinicians assessing liver disease severity may also find our Child Pugh Calculator useful for staging cirrhosis, and the MELD 3.0 Calculator for the latest version of the scoring system. Other related tools include the AST ALT Ratio Calculator for evaluating liver enzyme patterns and the Corrected Calcium Calculator for adjusting calcium levels in patients with liver disease-related hypoalbuminemia.


Formulas used

MELD(i) Score
\text{MELD}(i) = 3.78 \ln(\text{Bilirubin}) + 11.2 \ln(\text{INR}) + 9.57 \ln(\text{Creatinine}) + 6.43
MELD Na Score (when MELD(i) > 11)
\text{MELD Na} = \text{MELD}(i) + 1.32 \times (137 - \text{Na}) - 0.033 \times \text{MELD}(i) \times (137 - \text{Na})
Input Clamping Rules
\text{Cr}_{\text{used}} = \min(\max(\text{Cr},\,1),\,4), \quad \text{Bili}_{\text{used}} = \max(\text{Bili},\,1), \quad \text{INR}_{\text{used}} = \max(\text{INR},\,1), \quad \text{Na}_{\text{used}} = \min(\max(\text{Na},\,125),\,137)
Final Score (rounded and capped)
\text{Final} = \min\!\left(\operatorname{round}(\text{MELD Na}),\, 40\right)

Frequently asked questions

What lab tests do I need before using the MELD Na Calculator?

You need four lab values from a recent blood test: creatinine, total bilirubin, INR, and sodium (Na). You also need to know if the patient has been on dialysis two or more times in the past week or on CVVHD for 24 hours or more.

What is the difference between MELD and MELD Na?

The original MELD score uses only creatinine, bilirubin, and INR. MELD Na adds sodium to the formula. This makes it better at predicting 90-day mortality, especially in patients with low sodium. UNOS switched to MELD Na in January 2016 for liver transplant listing.

What is MELD(i) and how is it different from MELD Na?

MELD(i) is the base score calculated from creatinine, bilirubin, and INR before sodium is added. MELD Na is the final score after the sodium adjustment is applied. If MELD(i) is 11 or less, no sodium adjustment is made and both scores are the same.

Why is my creatinine locked at 4.0 when I select dialysis?

When a patient is on dialysis, their kidneys are already failing severely. The UNOS formula automatically sets creatinine to 4.0 mg/dL in this case. This prevents the creatinine value from understating how sick the patient is.

Why are some of my lab values changed automatically?

The MELD Na formula has built-in floors and caps. Creatinine, bilirubin, and INR below 1.0 are raised to 1.0. Creatinine above 4.0 is capped at 4.0. Sodium below 125 is raised to 125, and sodium above 137 is lowered to 137. These rules come from the official UNOS/OPTN policy.

Can I enter lab values in different units?

Yes. You can enter creatinine in mg/dL or µmol/L and bilirubin in mg/dL or µmol/L. Click the unit button next to each field to switch. The calculator converts the value for you automatically. Sodium is always entered in mEq/L.

Why does sodium not change my score?

The sodium adjustment only applies when the base MELD(i) score is greater than 11. If your MELD(i) is 11 or less, sodium has no effect on the final score. The results panel will tell you whether the sodium adjustment was applied.

What is the highest possible MELD Na score?

The highest possible MELD Na score is 40. Even if the raw calculation goes above 40, the final score is capped at 40. The lowest practical score is 6.

How accurate is the 3-month mortality estimate?

The mortality percentages shown are population-level estimates based on published research. They show the average risk for groups of patients within each score range. An individual patient's actual risk can be higher or lower depending on other health factors.

Can I use this calculator for children?

MELD Na is validated for patients 12 years and older. For children under 12, doctors use a different score called PELD (Pediatric End-Stage Liver Disease). Do not use this calculator for younger children.

How often should the MELD Na score be recalculated?

For transplant candidates, UNOS requires updated lab values at regular intervals. Patients with higher scores need more frequent updates — sometimes every 7 days. Your transplant center will tell you how often to recheck labs.

Does this calculator give MELD exception points?

No. Some conditions like hepatocellular carcinoma (HCC) qualify for MELD exception points that are added by the transplant center. This calculator only computes the standard MELD Na score from lab values. Exception points are handled separately by UNOS.

What does CVVHD mean in the dialysis question?

CVVHD stands for Continuous Veno-Venous Hemodialysis. It is a type of dialysis used in hospital settings, often in intensive care. If a patient had CVVHD for 24 hours or more in the past week, you should select "Yes" for dialysis.

Can medications or recent procedures affect my MELD Na score?

Yes. Certain medications like warfarin can raise the INR, and IV fluids can change sodium levels. Recent procedures or blood transfusions may also affect lab values. Use the most recent and accurate lab results for the best score.

Is the MELD Na score the same as MELD 3.0?

No. MELD 3.0 is a newer version introduced in 2022 that adds sex and albumin to the formula. MELD Na uses creatinine, bilirubin, INR, and sodium. Both scores are used in transplant decisions, but they are calculated differently.