NDT Advance Access published online on July 19, 2005
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh988
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
1 Department of Internal Medicine, Stavanger University Hospital; Institute of Internal Medicine, University of Bergen
* To whom correspondence should be addressed. Background. Secondary hyperparathyroidsm is frequently observed in patients with chronic renal failure, and clinical treatment guidelines have been published. Despite this, a large proportion of patients do not reach the target levels for calcium, phosphorus, calcium x phosphorus product, or intact parathyroid hormone. The use of albumin-corrected calcium is recommended as calcium measurement, but it is the concentration of ionized calcium that is biologically active. We hypothesized that in clinical practice, the use of ionized calcium rather than albumin-corrected calcium would influence the calcium classification of the individual patient. Methods. Blood samples from 34 patients in chronic haemodialysis were analysed for evaluation of mineral metabolism according to K/DOQI guidelines. Blood for analysis of total and ionized calcium was drawn simultaneously. As ionized calcium is pH dependent, samples were analysed at the actual pH of the individual patient. Results. For both methods, a similar number of patients were characterized as normocalcaemic. The use of albumin-corrected calcium caused one patient (3%) to be classified as hypocalcaemic, and 10 patients (26%) as hypercalcaemic whereas with ionized calcium, five (15%) and three patients (9%) were classified as hypo- and hypercalcaemic, respectively. Conclusions. According to present guidelines, the difference in calcium classification of patients might have clinical implications for the prescription of vitamin D, and on the choice of phosphate binders.
Received February 4, 2005
Accepted June 8, 2005
Original Articles
Albumin-corrected or ionized calcium in renal failure? What to measure?
yvind Skadberg 2,
2 Department of Internal Medicine, Stavanger University Hospital; Department of Medical Biochemistry, Stavanger University Hospital
Lasse G. Gøransson, E-mail: gola{at}sir.no
Abstract 
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Froissart, P. Houillier, and on behalf of the Nephro Test Study Group Limitations of non-corrected and albumin-corrected total calcium concentrations in CKD patients Nephrol. Dial. Transplant., July 1, 2009; 24(7): 2291 - 2292. [Full Text] [PDF]
|
|
|
|
|
|
L. Labriola, P. Wallemacq, B. Gulbis, and M. Jadoul The impact of the assay for measuring albumin on corrected ('adjusted') calcium concentrations Nephrol. Dial. Transplant., June 1, 2009; 24(6): 1834 - 1838. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Jain, S. Bhayana, M. Vlasschaert, and A. House A formula to predict corrected calcium in haemodialysis patients Nephrol. Dial. Transplant., September 1, 2008; 23(9): 2884 - 2888. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Gauci, O. Moranne, B. Fouqueray, R. de la Faille, G. Maruani, J.-P. Haymann, C. Jacquot, J.-J. Boffa, M. Flamant, J. Rossert, et al. Pitfalls of Measuring Total Blood Calcium in Patients with CKD J. Am. Soc. Nephrol., August 1, 2008; 19(8): 1592 - 1598. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. M. Calvi and D. A. Bushinsky When Is It Appropriate to Order an Ionized Calcium? J. Am. Soc. Nephrol., July 1, 2008; 19(7): 1257 - 1260. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Houillier, M. Froissart, G. Maruani, and A. Blanchard What serum calcium can tell us and what it can't Nephrol. Dial. Transplant., January 1, 2006; 21(1): 29 - 32. [Full Text] [PDF]
|
|