Advertisement

Journal of Endocrinological Investigation

, Volume 28, Issue 7, pp RC15–RC17 | Cite as

Prevalence of hypercalcemia in hospitalised patients: Effects of “correction” for serum albumin values

  • V. CarnevaleEmail author
  • M. Pipino
  • M. Antonacci
  • C. Checchia
  • V. D’Alessandro
  • M. Errico
  • A. Greco
  • A. Varriale
Rapid Communications

Abstract

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.

Key-words

Calcium serum albumin hypercalcemia 

References

  1. 1.
    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
  2. 2.
    Frolich A, McNair P, Transbol I. Awareness of hypercalcemia in a hospital population? Scand J Clin Lab Invest 1991, 51: 37–41.PubMedCrossRefGoogle Scholar
  3. 3.
    Frolich A. Prevalence of hypercalcemia in normal and in hospital populations. Dan Med Bull 1998, 45: 436–9.PubMedGoogle Scholar
  4. 4.
    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
  5. 5.
    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
  6. 6.
    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
  7. 7.
    Carroll MF, Schade DS. A practical approach to hypercalcemia. Am Fam Physician 2003, 67: 1959–66.PubMedGoogle Scholar
  8. 8.
    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
  9. 9.
    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
  10. 10.
    Besarab A, Caro JF. Increased absolute calcium binding to albumin in hypoalbuminemia. J Clin Pathol 1981, 34: 1368–74.PubMedCentralPubMedCrossRefGoogle Scholar
  11. 11.
    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
  12. 12.
    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
  13. 13.
    Pedersn KO. An analysis of measured and calculated calcium quantities in serum. Scand J Clin Lab Invest 1978, 38: 659–67.CrossRefGoogle Scholar
  14. 14.
    Hill PG. The measurement of albumin in serum and plasma. Ann Clin Biochem 1985, 22: 565–78.PubMedCrossRefGoogle Scholar
  15. 15.
    Shek CC, Natkinam A, Tsang V, Cockram CS, Swaminathan R. Incidence, causes and mechanism of hypercalcemia in a hospital population in Hong Kong. Q J Med 1990, 77: 1277–85.PubMedCrossRefGoogle Scholar

Copyright information

© Italian Society of Endocrinology (SIE) 2005

Authors and Affiliations

  • V. Carnevale
    • 1
    Email author
  • M. Pipino
    • 1
  • M. Antonacci
    • 2
  • C. Checchia
    • 2
  • V. D’Alessandro
    • 1
  • M. Errico
    • 1
  • A. Greco
    • 1
  • A. Varriale
    • 1
  1. 1.Dipartimento di Medicina InternaOspedale “Casa Sollievo della Sofferenza” IRCCSSan Giovanni Rotondo (FG)Italia
  2. 2.Department of Clinical Chemistry“Casa Sollievo della Sofferenza” Hospital, IRCCSSan Giovanni Rotondo (FG)Italy

Personalised recommendations