Title :

Calcium state estimation by total calcium: the evidence to end the never-ending story

Author(s) :

Pekar, Jean-David [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Grzych, Guillaume [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Durand, Gatien [Auteur]
Haas, Joel [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U 1011 [RNMCD]
Lionet, Arnaud [Auteur]
Service de Néphrologie et Transplantation rénale [CHRU-lille]
Brousseau, Thierry [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Glowacki, Francois [Auteur]
Impact de l'environnement chimique sur la santé humaine - ULR 4483 [IMPECS]
Maboudou, Patrice [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]

Journal title :

Clinical Chemistry and Laboratory Medicine

Abbreviated title :

Clin. Chem. Lab. Med.

Volume number :

58

Pages :

222-231

Publisher :

De Gruyter

Publication date :

2019-09-02

ISSN :

1437-4331

Keyword(s) :

Payne formula
total calcium
albumin-adjusted calcium
acid-base disorder
ionized calcium
mineral and bone metabolism disorders

HAL domain(s) :

Sciences du Vivant [q-bio]

English abstract : [en]

Total blood calcium (TCa) is routinely used to diagnose and manage mineral and bone metabolism disorders. Numerous laboratories adjust TCa by albumin, though literature suggests there are some limits to this approach. Here ...
Show more >Total blood calcium (TCa) is routinely used to diagnose and manage mineral and bone metabolism disorders. Numerous laboratories adjust TCa by albumin, though literature suggests there are some limits to this approach. Here we report a large retrospective study on agreement rate between ionized calcium (iCa) measurement and TCa or albumin-adjusted calcium measurements. Methods We retrospectively selected 5055 samples with simultaneous measurements of iCa, TCa, albumin and pH. We subgrouped our patients according to their estimated glomerular filtration rate (eGFR), albumin levels and pH. We analyzed each patient's calcium state with iCa as reference to determine agreement rate with TCa and albumin-adjusted calcium using Payne, Clase, Jain and Ridefelt formulas. Results The Payne formula performed poorly in patients with abnormal albumin, eGFR or pH levels. In patients with low albumin levels or blood pH disorders, Payne-adjusted calcium may overestimate the calcium state in up to 80% of cases. Similarly, TCa has better agreement with iCa in the case of hypoalbuminemia, but performed similarly to the Payne formula in patients with physiological albumin levels. The global agreement rate for Clase, Jain and Ridefelt formulas suggests significant improvement compared to Payne calcium adjustment but no significant improvement compared to TCa. Conclusions Total and albumin-adjusted calcium measurement leads to a misclassification of calcium status. Moreover, accurate calcium state determination depends on blood pH levels, whose measurement requires the same pre-analytical restrictions as iCa measurement. We propose that iCa should instead become the reference method to determine the real calcium state.Show less >

Language :

Anglais

Audience :

Internationale

Popular science :

Non

Administrative institution(s) :

CHU Lille
Inserm
Institut Pasteur de Lille
Université de Lille

Collections :

• IMPact de l'Environnement Chimique sur la Santé humaine (IMPECS) - ULR 4483
• Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (RNMCD) - U1011

Submission date :

2022-02-02T10:24:18Z
2024-03-13T09:14:59Z