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The plasma total calcium concentration is in the range of 2.2–2.6 mmol/L (9–10.5 mg/dL), and the normal ionized calcium is 1.3–1.5 mmol/L (4.5–5.6 mg/dL). [4] The amount of total calcium in the blood varies with the level of plasma albumin, the most abundant protein in plasma, and therefore the main carrier of protein-bound calcium in the blood.
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]
Because a significant portion of calcium is bound to albumin, any alteration in the level of albumin will affect the measured level of calcium. 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 ...
The amount of biologically active calcium varies with the level of serum albumin, a protein to which calcium is bound, and therefore levels of ionized calcium are better measures than a total calcium; however, one can correct a total calcium if the albumin level is known. [citation needed]
A basic metabolic panel including calcium is sometimes colloquially referred to as a "CHEM-8". Calcium, as an alkaline earth metal, is also an electrolyte, but abnormalities are more commonly associated with malnutrition, osteoporosis, or malignancy, especially of the thyroid. [citation needed]
Milk-alkali syndrome (MAS), also referred to as calcium-alkali syndrome, is the third most common cause of elevated blood calcium levels (hypercalcemia). [ 2 ] [ 3 ] Milk-alkali syndrome is characterized by hypercalcemia, metabolic alkalosis , and acute kidney injury .
The US Institute of Medicine (IOM) established Recommended Dietary Allowances (RDAs) for calcium in 1997 and updated those values in 2011. [6] See table. The European Food Safety Authority (EFSA) uses the term Population Reference Intake (PRIs) instead of RDAs and sets slightly different numbers: ages 4–10 800 mg, ages 11–17 1150 mg, ages 18–24 1000 mg, and >25 years 950 mg. [10]
Increased levels of protein in the urine, proteinuria, can be measured with a urine dipstick test. Three different tests may be used to measure calcium levels in urine, 24-hour urine tests, blood tests, and genetic tests. Measuring calcium levels can also be done using an oral calcium tolerance test. [24]