Adjust serum calcium in the setting of low albumin
Measured total calcium in serum consists of about 15% bound to organic and inorganic anions, about 40% bound to albumin, and the remaining as biologically active ionized calcium.
Therefore, serum total calcium may underestimate biologically active calcium levels in the hypoalbuminemic patient.
The adjustment formula is as follows:
Please note that this adjustment formula has been shown to inaccurate in patients with chronic kidney disease and end-stage renal disease
Payne RB, Little AJ, Williams RB, Milner JR.
Gauci C1, Moranne O, Fouqueray B, de la Faille R, Maruani G, Haymann JP, Jacquot C, Boffa JJ, Flamant M, Rossert J, Urena P, Stengel B, Souberbielle JC, Froissart M, Houillier P.
Measured total calcium in serum consists of about 15% bound to organic and inorganic anions, about 40% bound to albumin, and the remaining as biologically active ionized calcium.
Therefore, serum total calcium may underestimate biologically active calcium levels in the hypoalbuminemic patient.
The adjustment formula is as follows:
Please note that this adjustment formula has been shown to inaccurate in patients with chronic kidney disease and end-stage renal disease
Payne RB, Little AJ, Williams RB, Milner JR.
Gauci C1, Moranne O, Fouqueray B, de la Faille R, Maruani G, Haymann JP, Jacquot C, Boffa JJ, Flamant M, Rossert J, Urena P, Stengel B, Souberbielle JC, Froissart M, Houillier P.