How to use it
- Pick the units your lab uses for bilirubin and creatinine.
- Enter bilirubin, creatinine, INR and sodium.
- Tick dialysis if it was done at least twice in the past week.
- Read MELD-Na and MELD.
The formulas
With bilirubin and creatinine in mg/dL, after the UNOS limits (any value below 1 becomes 1; creatinine at most 4, or 4 after dialysis):
MELD(i) = 0.957 × ln(creatinine) + 0.378 × ln(bilirubin) + 1.120 × ln(INR) + 0.643
MELD is MELD(i) rounded to one decimal and multiplied by 10, at most 40.
When MELD is above 11, with sodium limited to 125–137 mmol/L:
MELD-Na = MELD + 1.32 × (137 − Na) − 0.033 × MELD × (137 − Na), rounded, at most 40.
Worked example
Bilirubin 2 mg/dL, creatinine 1.2 mg/dL, INR 1.5, sodium 132 mmol/L:
- MELD(i) = 0.957 × 0.1823 + 0.378 × 0.6931 + 1.120 × 0.4055 + 0.643 = 1.534, so MELD 15.
- MELD-Na = 15 + 1.32 × 5 − 0.033 × 15 × 5 = 19.1, so MELD-Na 19.
Tips
- Use results from the same day; MELD changes as the illness changes.
- Anticoagulants raise the INR and therefore MELD without reflecting liver function.
- This is an estimate for information, not a diagnosis or a treatment decision.