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Disorders of calcium metabolism occur when the body has too little or too much calcium. The serum level of calcium is closely regulated within a fairly limited range in the human body. In a healthy physiology, extracellular calcium levels are maintained within a tight range through the actions of parathyroid hormone , vitamin D and the calcium ...
Diagnosis should generally include either a calculation of corrected calcium or direct measurement of ionized calcium level and be confirmed after a week. [1] This is because either high or low serum albumin levels does not show the true levels of ionised calcium. [15]
A corrected calcium level based on the albumin level is: Corrected calcium (mg/dL) = measured total Ca (mg/dL) + 0.8 * (4.0 - serum albumin [g/dL]). [20] Since calcium is also bound to small anions, it may be more useful to correct total calcium for both albumin and the anion gap. [21] [22]
Calcium regulation in the human body. [6]The plasma ionized calcium concentration is regulated within narrow limits (1.3–1.5 mmol/L). This is achieved by both the parafollicular cells of the thyroid gland, and the parathyroid glands constantly sensing (i.e. measuring) the concentration of calcium ions in the blood flowing through them.
Therefore, it is important to correct the calculated value of the anion gap for the concentration of albumin, particularly in critically ill patients. [ 18 ] [ 19 ] [ 20 ] Corrections can be made for the albumin concentration using the Figge-Jabor-Kazda-Fencl equation to give an accurate anion gap calculation as exemplified below.
To calculate a corrected calcium in mmol/L one takes the total calcium in mmol/L and adds it to ((40 minus the serum albumin in g/L) multiplied by 0.02). [33] There is, however, controversy around the usefulness of corrected calcium as it may be no better than total calcium. [34]
Serum albumin, often referred to simply as blood albumin, is an albumin (a type of globular protein) found in vertebrate blood. Human serum albumin is encoded by the ALB gene . [ 2 ] [ 3 ] [ 4 ] Other mammalian forms, such as bovine serum albumin , are chemically similar.
Though calcium is the most plentiful electrolyte in the body, a large percentage of it is used to form the bones. [14] It is mainly absorbed and excreted through the GI system. [ 14 ] The majority of calcium resides extracellularly, and it is crucial for the function of neurons , muscle cells , function of enzymes , and coagulation . [ 14 ]