Understanding sodium balance: the Edelman formula and its significance: a narrative review of the literature.

Abstract

Clinicians have long faced challenges and decisions regarding sodium management in their patients. Clinicians must have a good understanding of the physiology of sodium, its metabolism, distribution in the body, and the consequences of an increase or decrease in its normal level since changes in sodium levels occur frequently in different settings of patient care and across different specialties. Multiple studies and several formulas are currently available to help manage cases with abnormal sodium levels. These tools require a detailed focus to benefit patients in the short and long term and to avoid consequences due to poor decisions resulting in osmotic demyelination syndrome. This review will consider different aspects of sodium metabolism, the role sodium has in patients with edema, the evolution sodium management has had since the development of the Edelman formula and different variations of his formula, and other considerations regarding sodium storage in the skin are currently relevant for a more in-depth approach to the management of patients with dysnatremias.