Ionized calcium in patients with chronic renal failure
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E Kumchev1, I Ledzhev, S Simeonov
1Clinic of Nephrology, University of Medicine, Plovdiv, Bulgaria.
Insights
In chronic renal failure (CRF), total serum calcium decreases, but ionized calcium levels remain stable, with a higher percentage of ionized calcium observed in patients compared to healthy individuals.
Area of Science:
- Nephrology
- Clinical Chemistry
Background:
- Chronic renal failure (CRF) affects mineral metabolism.
- Understanding calcium levels in CRF is crucial for patient management.
Purpose of the Study:
- To investigate serum calcium parameters in patients with chronic renal failure.
- To compare ionized and total serum calcium levels between CRF stages and healthy controls.
Main Methods:
- Studied 31 CRF patients and 30 healthy controls.
- Measured total serum calcium, ionized calcium, serum creatinine, creatinine clearance, and acid-base balance.
Main Results:
- Total serum calcium was significantly lower in later stages of CRF.
- Ionized calcium levels remained within reference ranges, with a higher percentage of ionized calcium in CRF patients.
- A negative correlation was found between ionized calcium and serum creatinine in advanced CRF stages.
Conclusions:
- CRF is associated with altered total serum calcium levels.
- Ionized calcium appears to be maintained in CRF, with potential implications for calcium regulation.
- Further research is needed to explore the clinical significance of these findings in CRF management.
Abstract:
Parameters of various renal disorders were studied in 31 patients (17 men and 14 women) who all were in the stage of chronic renal failure (CRF). These parameters included total serum creatinine, ionized calcium, serum creatinine, creatinine clearance and acid-base balance. The results were compared with a control group of 30 healthy subjects. In the patients with first stage CRF, the total serum calcium did not significantly decrease (mean = 2.19 +/- 0.12 mmol/l) and ionized calcium was within reference value limits (mean = 1.28 +/- 0.02 mmol/l). The percentage of ionized calcium in total serum calcium was higher for these patients (mean = 58.43%) than for the control group (mean = 52.25%). For patients with first and second stage CRF, the total serum was significantly lower (mean = 1.92 +/- 0.03 mmol/l) than for the healthy controls (p < 0.001) as well as for patients with first stage CRF (p < 0.05). The ionized calcium in these patients was not significantly lower (mean = 1.14 +/- 0.01 mmol/l); however, its percentage was higher than that of serum calcium (mean = 59.38%). There was a slight negative correlation between the levels of ionized calcium and serum creatinine in patients with first stage CRF (r = -0.30) and a significant correlation in patients with second and third stage CRF.