Hypercalcemia is ideally detected by the measurement of serum ionised calcium. Because this is not widely available, in common clinical practice “albumin-corrected” calcium values are often utilized. Our study investigated whether the method used to measure serum albumin concentration may significantly interfere in the derived serum calcium values and, consequently, in the identification of hypercalcemic patients. In 170 consecutive patients admitted to our Department of Internal Medicine we measured serum total calcium, total protein, and albumin by colorimetric method; albumin concentration was also derived by electrophoresis assessment. After correcting serum calcium for colorimetrically (CA) and electrophoretically (EA) measured albumin values, the detected frequencies of hypercalcemia were compared, utilizing different cut-off limits (i.e. 11.0, 10.4 and 10.2 mg/dl). In our patients, the CA values were significantly lower than EA levels. As a consequence, EA-corrected calcium, as well as total calcium concentration were significantly lower than CA-corrected values. This may also account for the very different prevalence of hypercalcemic patients identified by serum total, EA-corrected and CA-corrected calcium values. Our data therefore indicate the importance of the method of albumin measurement in the determination of “corrected“ calcium concentration.
Calcium serum albumin hypercalcemia
This is a preview of subscription content, log in to check access.
Palmer M, Jakobsson S, Akerstrom G, Ljunghall S. Prevalence of hypercalcemia in a health survey: a 14-year follow-up study of serum calcium values. Eur J Clin Invest 1988, 18: 39–46.PubMedCrossRefGoogle Scholar
Frolich A, McNair P, Transbol I. Awareness of hypercalcemia in a hospital population? Scand J Clin Lab Invest 1991, 51: 37–41.PubMedCrossRefGoogle Scholar
Frolich A. Prevalence of hypercalcemia in normal and in hospital populations. Dan Med Bull 1998, 45: 436–9.PubMedGoogle Scholar
Lundgren E, Rastad J, Thurfjell E, Akerstrom G, Ljunghall S. Population-based screening for primary hyperparathyroidism with serum calcium and parathyroid hormone values in meno-pausal women. Surgery 1997, 121: 287–94.PubMedCrossRefGoogle Scholar
Jorde R, Bonaa KH, Sundsfjord J. Primary hyperparathyroidism detected in a health screening. The Tromso study. J Clin Epidemiol 2000, 53: 1164–9.CrossRefGoogle Scholar
Lundgren E, Hagstrom EG, Lundin J, et al. Primary hyperparath-yroidism revisited in menopausal women with serum calcium in the upper normal range at population-based screening 8 years ago. World J Surg 2002, 26: 931–6.PubMedCrossRefGoogle Scholar
Carroll MF, Schade DS. A practical approach to hypercalcemia. Am Fam Physician 2003, 67: 1959–66.PubMedGoogle Scholar
LeBoff MS, Mikulec KH. Hypercalcemia: clinical manifestations, pathogenesis, diagnosis, and management. In: Murray JF ed. Primer on the Metabolic Bone Diseases and Disorders of Mineral Metabolism. 5th ed. 2003, 225–30.Google Scholar
Eustace JA, Astor B, Muntner PM, Ikizler TA, Coresh J. Prevalence of acidosis and inflammation and their association with low serum albumin in chronic kidney disease. Kidney Int 2004, 65: 1031–40.PubMedCrossRefGoogle Scholar
Dickerson RN, Alexander KH, Minard G, Croce MA, Brown RO. Accuracy of methods to estimate ionised and “corrected” serum calcium concentrations in critically ill multiple trauma patients receiving specialized nutrition support. JPEN J Parent-er Enteral Nutr 2004, 28: 133–41.CrossRefGoogle Scholar
Bilezikian JP, Potts JT Jr, El Hajj Fuleihan G, et al. Summary statement from a workshop on asymptomatic primary hyperparathyroidism: a perspective for the 21st century. J Bone Miner Res 2002, 17 (Suppl2): N2–11.PubMedGoogle Scholar
Pedersn KO. An analysis of measured and calculated calcium quantities in serum. Scand J Clin Lab Invest 1978, 38: 659–67.CrossRefGoogle Scholar