Corrected calcium

[goat122]

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not sure if this is the right place to put this and it's probably a really stupid question, but i'm on rotation at a dialysis clinic and I know you're supposed to use corrected calcium if albumin is abnormal, but does that just mean when it's low or should I do corrected calcium on every patient whether albumin is abnormal or not? For example I have a patient with an albumin of 5.0 and calcium of 9.8. Do I use corrected calcium for this?

 

[awval999]

not sure if this is the right place to put this and it's probably a really stupid question, but i'm on rotation at a dialysis clinic and I know you're supposed to use corrected calcium if albumin is abnormal, but does that just mean when it's low or should I do corrected calcium on every patient whether albumin is abnormal or not? For example I have a patient with an albumin of 5.0 and calcium of 9.8. Do I use corrected calcium for this?

No.

 

[wahaha]

Could you just not do an ionized calcium?

 

[atpsynthase]

You could order the ionized calcium, but the problem with ionized calcium is the tests are not standardized and the tests are very sensitive to environmental conditions and the accuracy of the tests suffer. KDOQI guidelines also suggest use of corrected calcium... I believe I read there were a few instances were ionized calcium was superior to calculated corrected calcium via Ca2+ and albumin, but in general outpatient and non-critical patients, the corrected calcium should be used.

 

[wahaha]

You could order the ionized calcium, but the problem with ionized calcium is the tests are not standardized and the tests are very sensitive to environmental conditions and the accuracy of the tests suffer. KDOQI guidelines also suggest use of corrected calcium... I believe I read there were a few instances were ionized calcium was superior to calculated corrected calcium via Ca2+ and albumin, but in general outpatient and non-critical patients, the corrected calcium should be used.

The accuracy of the test doesn't suffer. It is It is the sample that is sensitive to these factors like pH, the presence of substances that complex the calcium. The general method of measuring free calcium is by ion selective electrode that is highly selective for calcium and at 37 degrees celsius. Most articles I've read suggest ionized calcium over the corrected whenerver possible. But granted, it is eaiser to use the corrected for outpatients and those that are not critically ill. But the corrected doesn't account for the different methods of measuring calcium and albumin.

 

[atpsynthase]

At any rate... without a doubt, its the future of determining calcium levels