MELD-Na: Model for End-Stage Liver Disease — Sodium

3-month mortality in advanced liver disease; transplant prioritization. Free to use.

gastroenterology, hepatology 5 items Updated 2026-05-05

Score MELD-Na below → Download printable PDF View source paper (DOI)

What is MELD-Na? MELD-Na (Model for End-Stage Liver Disease — Sodium) is a validated instrument used to assess 3-month mortality in advanced liver disease; transplant prioritization. It comprises 5 items.

What is MELD-Na?

MELD-Na (Model for End-Stage Liver Disease — Sodium) is a validated clinical instrument used to assess 3-month mortality in advanced liver disease; transplant prioritization. The instrument contains 5 items.

Source / attribution: Kim WR et al., NEJM 2008 (UNOS implementation 2016)

Full name	Model for End-Stage Liver Disease — Sodium
Measures	3-month mortality in advanced liver disease; transplant prioritization
Specialty	gastroenterology, hepatology
Number of items	5
Scoring method	formula
License	Public domain — free to use
Last updated	2026-05-05
Algorithm version	1.0

Clinical context: when MELD-Na is used

Like all screening or assessment instruments, MELD-Na is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.

Score MELD-Na

Answer all 5 items below to see your MELD-Na score and interpretation.

All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.

How MELD-Na is scored

MELD-Na uses a published formula (meld-na) rather than simple summation. The formula and its inputs are visible in our open-source scoring engine.

Scoring notes: Educational use only. Floors and caps applied per UNOS rules.

MELD-Na score interpretation

The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.

Score range	Band	Interpretation
6–9	Low	Lower mortality risk.
10–19	Moderate	Moderate mortality risk.
20–29	High	High mortality risk.
30–40	Very high	Very high mortality risk.

How to score MELD-Na: worked example

MELD-Na uses a published formula rather than simple summation. Below is a step-by-step calculation with illustrative inputs.

Step 1 — Collect the inputs

Input	Value
Bilirubin	2.0 mg/dL
INR	1.5
Creatinine	1.5 mg/dL
Sodium	135 mEq/L

Step 2 — Apply the formula

Bound each value to the safe range. Lab values below 1.0 are floored to 1.0; sodium is bounded to 125–137.
Compute the original MELD: MELD = 3.78 × ln(2.0) + 11.2 × ln(1.5) + 9.57 × ln(1.5) + 6.43 ≈ 17.5
Apply the sodium correction (only if Na < 137): MELD-Na = 17.5 + 1.32 × (137 − 135) − 0.033 × 17.5 × (137 − 135) ≈ 19
Round to the nearest integer and clamp to 6–40.

Step 3 — Read the result

Score = 19 → Moderate — Moderate mortality risk.

Use the calculator above with your own values →

Limitations & common pitfalls

Educational use only. Floors and caps applied per UNOS rules.
Screening, not diagnosis. A positive MELD-Na score is not equivalent to a diagnosis. Confirmatory clinical evaluation is required before treatment decisions.
Population calibration. Cutoffs were derived from specific validation populations. Performance can differ in other age groups, languages, comorbid conditions, or clinical settings.
Self-report bias. Patient-reported instruments are subject to under- and over-reporting; clinical context is essential.

How MELD-Na compares to other gastroenterology scales

If MELD-Na doesn't fit your context, related instruments in gastroenterology include:

Scale	Measures	Items	Time
Child-Pugh	Severity of cirrhosis and prognosis	5	—
Glasgow-Blatchford	Pre-endoscopy risk in upper GI bleeding	9	—
ASA Physical Status	Pre-operative health status	1	—
Barthel Index	Functional independence in ADLs	10	—
BDI-II	Severity of depression	—	≈ 5 minutes
CHA2DS2-VASc	Annual stroke risk in non-valvular atrial fibrillation	8	—
CURB-65	30-day mortality in community-acquired pneumonia	5	—
Glasgow Coma Scale	Level of consciousness after head injury	3	—

Frequently asked questions about MELD-Na

What does MELD-Na measure?

MELD-Na (Model for End-Stage Liver Disease — Sodium) is a validated instrument that assesses 3-month mortality in advanced liver disease; transplant prioritization.

How many items are on MELD-Na?

MELD-Na contains 5 items.

What is a high MELD-Na score?

Scores of 30–40 fall in the "Very high" band. Very high mortality risk.

What is a low MELD-Na score?

Scores of 6–9 fall in the "Low" band. Lower mortality risk.

Is MELD-Na free to use?

Yes — MELD-Na is in the public domain and free for clinical, educational, and research use without permission.

What is the source paper for MELD-Na?

Kim WR et al. N Engl J Med. 2008;359(10):1018-1026.

Can MELD-Na replace clinical judgment?

No. MELD-Na is a structured assessment aid. A score is one input alongside history, examination, and clinical context. Treatment decisions should never rest on a screening score alone.

References & validation

MELD-Na is supported by the following peer-reviewed sources:

Kim WR et al. N Engl J Med. 2008;359(10):1018-1026. doi:10.1056/NEJMoa0801209