Skip to main content
SpringerLink
Log in

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

  • Rapid Communications
  • Published:
Journal of Endocrinological Investigation Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  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.

    Article  CAS  PubMed  Google Scholar 

  2. Frolich A, McNair P, Transbol I. Awareness of hypercalcemia in a hospital population? Scand J Clin Lab Invest 1991, 51: 37–41.

    Article  CAS  PubMed  Google Scholar 

  3. Frolich A. Prevalence of hypercalcemia in normal and in hospital populations. Dan Med Bull 1998, 45: 436–9.

    CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  5. Jorde R, Bonaa KH, Sundsfjord J. Primary hyperparathyroidism detected in a health screening. The Tromso study. J Clin Epidemiol 2000, 53: 1164–9.

    Article  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  7. Carroll MF, Schade DS. A practical approach to hypercalcemia. Am Fam Physician 2003, 67: 1959–66.

    PubMed  Google Scholar 

  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.

  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.

    Article  CAS  PubMed  Google Scholar 

  10. Besarab A, Caro JF. Increased absolute calcium binding to albumin in hypoalbuminemia. J Clin Pathol 1981, 34: 1368–74.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  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.

    Article  CAS  Google Scholar 

  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.

    PubMed  Google Scholar 

  13. Pedersn KO. An analysis of measured and calculated calcium quantities in serum. Scand J Clin Lab Invest 1978, 38: 659–67.

    Article  Google Scholar 

  14. Hill PG. The measurement of albumin in serum and plasma. Ann Clin Biochem 1985, 22: 565–78.

    Article  CAS  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Dipartimento di Medicina Interna, Ospedale “Casa Sollievo della Sofferenza” IRCCS, Viale dei Cappuccini, 71013, San Giovanni Rotondo (FG), Italia

    V. Carnevale MD, M. Pipino, V. D’Alessandro, M. Errico, A. Greco & A. Varriale

  2. Department of Clinical Chemistry, “Casa Sollievo della Sofferenza” Hospital, IRCCS, San Giovanni Rotondo (FG), Italy

    M. Antonacci & C. Checchia

Authors
  1. V. Carnevale MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. Pipino
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. M. Antonacci
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. C. Checchia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. V. D’Alessandro
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. M. Errico
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. A. Greco
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. A. Varriale
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to V. Carnevale MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carnevale, V., Pipino, M., Antonacci, M. et al. Prevalence of hypercalcemia in hospitalised patients: Effects of “correction” for serum albumin values. J Endocrinol Invest 28, RC15–RC17 (2005). https://doi.org/10.1007/BF03347215

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF03347215

Key-words

Search

Navigation