Serum Osmolality (SI)

Enter serum electrolytes (mmol/L) and optionally measured osmolality to estimate calculated osmolality and osmolar gap.

Including K⁺ increases accuracy slightly; omit if unavailable.

Needed to compute osmolar gap. Leave blank if unavailable.

Calculated osmolality

298.0 mOsm/kg

Osmolar gap

-298.0 mOsm/kg

Hyperosmolar status suspected (hypernatremia, hyperglycaemia, mannitol). Assess osmolar gap and clinical scenario. Osmolar gap >10 mOsm/kg suggests unmeasured osmoles (toxic alcohols, ketoacids, lactic acidosis).

How to Use This Calculator

1

Collect SI laboratory values

Use mmol/L for sodium, potassium, glucose, and urea. Convert mg/dL values if necessary (glucose mg/dL ÷ 18, urea mg/dL ÷ 2.8).

2

Calculate osmolality

The calculator applies 2 × (Na⁺ + K⁺) + glucose + urea. Potassium is optional and defaults to 0 if omitted.

3

Compare to measured osmolality

Enter measured serum osmolality (osmometer) to obtain the osmolar gap. Gaps >10–15 mOsm/kg indicate unmeasured osmoles.

Formula

Serum osmolality (mOsm/kg) = 2 × (Na⁺ + K⁺) + Glucose + Urea (all in mmol/L)

Osmolar gap = Measured osmolality − Calculated osmolality

Normal osmolar gap ≈ −10 to +10 mOsm/kg.

Full Description

Calculated serum osmolality estimates total solute concentration using major contributors (sodium, potassium, glucose, urea). Comparing calculated to measured osmolality yields the osmolar gap, a tool for detecting unmeasured osmoles such as toxic alcohols or organic acids. Always interpret alongside acid-base status, lactate, and clinical findings, and repeat testing if results are unexpected.

Frequently Asked Questions

Why use SI units?

Many laboratories outside the US report mmol/L. This calculator simplifies calculations without unit conversion.

Do I need potassium?

Potassium contributes minimally. If omitted, the formula defaults to Na⁺ only (2 × Na⁺ + glucose + urea).

What indicates a significant osmolar gap?

An osmolar gap >10–15 mOsm/kg suggests unmeasured osmoles (methanol, ethylene glycol, propylene glycol, isopropanol, ketoacids, lactic acidosis).

How does this differ from plasma osmolality?

Both estimate tonicity. The plasma calculator uses mg/dL inputs and includes ethanol adjustment; choose the tool that matches your lab units.