Calculated vs measured plasma osmolalities revisited.

Bhagat, C I; Garcia-Webb, P; Fletcher, E; Beilby, J P

doi:10.1093/clinchem/30.10.1703

Cited by 90Clinical Laboratory Practices and Quality ControlElectrolyte and hormonal disordersHemodynamic Monitoring and Therapy

Calculated vs measured plasma osmolalities revisited.

Bhagat, C I, Garcia-Webb, P, Fletcher, E, Beilby, J P·1984·Clinical Chemistry

DOI 10.1093/clinchem/30.10.1703

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Abstract

The osmolalities of 100 plasma samples were measured and compared with the osmolalities calculated from the plasma concentrations (mmol/L) of sodium, potassium, glucose, and urea by several different formulae. The formula recommended by Dorwart and Chalmers (Clin Chem 21: 190, 1975) gave inferior results to those obtained with our "most accurate" formula: osmolality = 1.89 Na + 1.38 K + 1.03 urea + 1.08 glucose + 7.45. We recommend using this formula for calculation of osmolality on equipment linked to a computer. However, for simplicity, and to reduce the possibility of calculation errors, the following formula can be used for manual calculations: osmolality = 1.86 (Na + K) + glucose + urea + 10.

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Antidiuretic hormone concentration is defined depending on serum osmolality, which value can be considered as function of plasma sodium concentration and levels of glucose and urea in blood.
“Antidiuretic hormone concentration is defined depending on serum osmolality (Hammer et al., 1980), which value can be considered as function of plasma sodium concentration and levels of glucose and urea in blood (Dorwart and Chalmers, 1975; Bhagat et al., 1984).”
From Thoroughly Calibrated Modular Agent-Based Model of the Human Cardiovascular and Renal Systems for Blood Pressure Regulation in Health and Disease (2021) · cites this paper as Bhagat et al., 1984

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Wilgen, U., Pretorius, C. J., & Ungerer, J. P. J. (2017) · Annals of Clinical Biochemistry International Journal of Laboratory Medicine · doi:10.1177/0004563217694052 · Cited by 2 · see citing works
Osmolal gap and malnutrition in hemodialysed patients
Duma, D., Wojtysiak-Duma, B., Lodek, S., et al. (2008) · Annales UMCS Pharmacia · doi:10.2478/v10080-008-0069-y · Cited by 2 · see citing works
Osmolality as a strong predictor of COVID-19 mortality and its possible links to other biomarkers
Çetin, Ş., Ülgen, A., Şıvgın, H., Çetin, M., & Li, W. (2025) · PLoS ONE · doi:10.1371/journal.pone.0331344 · Cited by 1 · see citing works
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McMurray, J. J. V., Seidelin, P. H., & Fraser, D. M. (1987) · Practical Diabetes · doi:10.1002/pdi.1960040210
Osmolal Gap as a Biomarker in Kidney Injury: Focusing on the Differential Diagnosis of Metabolic Acidosis
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Comparison of measured ethanol and calculated ethanol using osmolal gap and osmolarity formulas
Börü, E. G. (2017) · International journal of medical biochemistry/International journal of medical biochemistry : · doi:10.14744/ijmb.2017.22931
“In the literature, many formulas have been defined for osmolality calculation and ethanol estimation; however, there is still no consensus on which formula is most accurate [15-20].”
Background
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Vechiato, F. M. V. (2018) · doi:10.11606/d.17.2018.tde-10082015-103622
Outcome of Comparison Study Of Various Equations For Serum Osmolality
Saraswathy, A., Pavai, S., Nadiah, Z., & Yunus, P. J. M. (2019) · Asian Journal of Medicine and Biomedicine
The Association between Serum Osmolality and Functional Myocardial Ischemia in Patients With Type-2 Diabetes Mellitus
Gülcü, O., Aksu, U., Aksakal, E., Birdal, O., Kalkan, K., Bayram, E., Topçu, S., & Tanboğa, İ. H. (2018) · Archives of Diabetes and Endocrine System · doi:10.22259/2638-4981.0101002
Optimising outcomes after liver transplantation: pathophysiology of biliary injury and the application of machine perfusion
Reiling, J. (2017) · The University of Queensland · doi:10.14264/uql.2017.886
Acid–base balance and disorders
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Osmolal Gap as a Biomarker in Kidney Injury: Focusing on the Differential Diagnosis of Metabolic Acidosis
Lee, J., Heo, N. J., & Han, J. S. (2015) · Springer eBooks · doi:10.1007/978-94-007-7743-9_14-1
“Most studies, however, have concluded that the calculated serum osmolality can be best estimated from the following formulae (Worthley et al. 1987; Purssel et al. 2001; Bhagat et al. 1984):”
Background

Authors: Bhagat, C. I., Garcia-Webb, P., Fletcher, E., & Beilby, J. P.
ORCID: Beilby, J P
Venue: Clinical Chemistry
Publisher: Oxford University Press (OUP)
Published: 1984-10-01
Volume: 30
Issue: 10
Pages: 1703-1705
ISSN: 0009-9147 (ISSN-L)
1530-8561
DOI: 10.1093/clinchem/30.10.1703
OpenAlex: W1913741217
Cited by: 90
References: 0
Citations by year: 2025: 2 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 6 · 2019: 5 · 2018: 5 · 2017: 9 · 2016: 6 · 2015: 10 · 2014: 4 · 2013: 2 · 2012: 5
FWCI: 1.48
Type: journal article
Language: en
Open access: closed
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: Clinical Chemistry (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Electrolyte and hormonal disorders
Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
Keywords: plasma osmolality, sodium, potassium, glucose, urea, manual calculation
MeSH terms: Blood Chemical Analysis, Blood Glucose, Diabetes Mellitus, Humans, Hypernatremia, Hyponatremia, Kidney Failure, Chronic, Osmolar Concentration, Potassium, Sodium, Urea

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Calculated vs measured plasma osmolalities revisited.

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