Pitfalls of measuring total blood calcium in patients with CKD

Journal of the American Society of Nephrology : JASN
Cédric GauciNephrotest Study Group

Abstract

Disorders of mineral and bone metabolism are prevalent in patients with chronic kidney disease (CKD). The recent National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines recommend that blood calcium (Ca) be regularly measured in patients with stages 3 to 5 CKD. The Kidney Disease: Improving Global Outcomes (KDIGO) position states that the measurement of ionized Ca (iCa) is preferred and that if total Ca (tCa) concentration is used instead, then it should be adjusted in the setting of hypoalbuminemia. In 691 consecutive patients with stages 3 to 5 CKD, we compared the ability of noncorrected and albumin-corrected tCa concentration to identify low, normal, or high iCa concentration. The agreement between noncorrected or albumin-corrected tCa and iCa was only fair. The risk for underestimating ionized calcium was independently increased by a low total CO(2) concentration when either noncorrected or albumin-corrected Ca was used and by a low albumin concentration only when noncorrected tCa was used. The risk for overestimating iCa was increased by a low albumin concentration only when albumin-corrected Ca was used. In conclusion, albumin-corrected tCa does not predict iCa better than noncorrected tC...Continue Reading

References

Jun 1, 1989·Scandinavian Journal of Clinical and Laboratory Investigation·B GougetA Truchaud
Nov 1, 1972·Scandinavian Journal of Clinical and Laboratory Investigation·J Bröchner-Mortensen
Dec 1, 1971·Clinica Chimica Acta; International Journal of Clinical Chemistry·D H Orrell
Nov 10, 2000·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·C M ClaseD N Churchill
Jul 31, 2004·Journal of the American Society of Nephrology : JASN·Geoffrey A BlockGlenn M Chertow
Oct 8, 2004·The New England Journal of Medicine·Alexander KratzKent B Lewandrowski
Jan 22, 2005·Journal of the American Society of Nephrology : JASN·Marc FroissartPascal Houillier
Jul 21, 2005·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Lasse G GøranssonHarald Bergrem

Citations

Sep 14, 2012·Journal of Inherited Metabolic Disease·Nikolas BoyStefan Kölker
Feb 3, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Laura LabriolaMichel Jadoul
Apr 8, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Marc FroissartNephro Test Study Group
Aug 6, 2009·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Marie BrietMarc Froissart
Jul 6, 2012·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Guillaume JeanCharles Chazot
Feb 5, 2013·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Pierre DelanayeEtienne Cavalier
May 25, 2010·Seminars in Dialysis·A Ross MortonRachel M Holden
Oct 31, 2012·Nephron. Clinical Practice·Elin Isaksson, Gunnar Sterner
Apr 16, 2011·Journal of the American Society of Nephrology : JASN·Marie BrietNephrotest Study Group
Sep 11, 2010·Clinical Journal of the American Society of Nephrology : CJASN·Pieter EvenepoelYves Vanrenterghem
Jul 19, 2014·Néphrologie & thérapeutique·Guillaume Jean
May 24, 2011·International Journal of Nephrology·Luigi Francesco MorroneBiagio Di Iorio
Oct 15, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Masafumi FukagawaShunichi Fukuhara
Jun 8, 2013·Néphrologie & thérapeutique·Pierre DelanayeEtienne Cavalier
Sep 3, 2011·La Presse médicale·Guillaume Jean
Apr 7, 2010·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Katrin UhligStanley Goldfarb
Oct 13, 2009·Burns : Journal of the International Society for Burn Injuries·Barbara KohutMette M Berger
Nov 24, 2011·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Akihiko KatoYukitaka Maruyama
Aug 8, 2015·Clinical Kidney Journal·Guillaume JeanCharles Chazot
Jan 18, 2014·Saudi Journal of Kidney Diseases and Transplantation : an Official Publication of the Saudi Center for Organ Transplantation, Saudi Arabia·Mona Al RukhaimiFaissal A M Shaheen
Apr 18, 2015·Annales d'endocrinologie·Jean-Claude SouberbielleCatherine Cormier
May 10, 2012·Clinical Biochemistry·David B Endres
Oct 8, 2016·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Yoshitsugu ObiKamyar Kalantar-Zadeh
Feb 13, 2017·Journal of Veterinary Internal Medicine·D H N van den BroekR E Jepson
Jan 18, 2018·Journal of Bone and Mineral Research : the Official Journal of the American Society for Bone and Mineral Research·Yoshitsugu ObiElani Streja
Mar 28, 2018·Scientific Reports·Cynthia J JanmaatJuan Jesus Carrero
Nov 29, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Yusuke SakaguchiYoshitaka Isaka
Mar 10, 2017·Clinical Journal of the American Society of Nephrology : CJASN·Mitchell H Rosner
Jan 24, 2015·Journal of the American Society of Nephrology : JASN·Matthew B RivaraRajnish Mehrotra
Apr 13, 2012·The Journal of Clinical Endocrinology and Metabolism·Peter KamenickýPhilippe Chanson
Apr 22, 2019·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Claudia LaminaJürgen Floege
Mar 22, 2014·The Korean Journal of Internal Medicine·Seok Hui KangJun Young Do
Sep 2, 2019·Clinical Chemistry and Laboratory Medicine : CCLM·Jean-David PekarPatrice Maboudou
Sep 16, 2015·Current Opinion in Nephrology and Hypertension·Guillaume Jean, Charles Chazot
Jun 15, 2017·Scandinavian Journal of Clinical and Laboratory Investigation·Peter Ridefelt, Johanna Helmersson-Karlqvist
May 24, 2020·The Journal of Applied Laboratory Medicine·Ernie YapPhilip Goldwasser
Feb 18, 2016·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Yoshio KakuKaoru Tabei
Nov 28, 2020·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Sevcan A BakkalogluEuropean Society for Paediatric Nephrology (ESPN) Chronic Kidney Disease Mineral and Bone Disorder (CKD-MBD) and Dialysis wo

Related Concepts

Calcium
Plasma Albumin
Chronic Kidney Insufficiency
Albumins
Metabolic Bone Disorder
Calcium
Hypercalcemia
Kidney Diseases
Minerals
Hypoalbuminemia

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