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Reference ranges for ionized calcium in plasma in Danish children aged 0 days to 3 years using laboratory registry

Anne-Sofie Allermann Faarvang1,2, Thomas S Rosengren1, Lars E Pedersen1

  • 1Department of Clinical Biochemistry, Næstved Slagelse Ringsted Hospitals, Slagelse, Region Zealand, Denmark.

Clinical Chemistry and Laboratory Medicine
|August 11, 2025
PubMed

Insights

This study establishes new reference ranges for ionized calcium in pediatric plasma, showing a rise after birth and a subsequent decrease, crucial for accurate calcium metabolism assessment in infants.

Area of Science:

  • Clinical Chemistry
  • Pediatric Endocrinology
  • Biomarker Analysis

Background:

  • Ionized calcium measurement is vital for calcium metabolism assessment.
  • Establishing accurate reference ranges for ionized calcium in pediatric populations is challenging.
  • Current reference ranges may not adequately reflect physiological variations in young children.

Purpose of the Study:

  • To establish novel, accurate reference ranges for plasma ionized calcium in a pediatric population (0-3 years).
  • To provide updated data for improved clinical assessment of calcium metabolism in infants and young children.
  • To analyze trends in ionized calcium levels during early life.

Main Methods:

  • Retrospective analysis of 20,516 ionized calcium measurements from 16,039 children (0-3 years) between 2012-2023.
  • Exclusion of samples from intensive care/nephrology and those with extreme pH values ( < 7.2 or > 7.6).
  • Establishment of both pH-corrected and non-corrected reference ranges, with single monthly measurements per child used for repeated samples.

Main Results:

  • Novel reference ranges for plasma ionized calcium were established, stratified by age groups.
  • A significant variation was observed in the first 10 days of life, with levels peaking around day eight.
  • Ionized calcium levels gradually decreased after day eight, stabilizing between 18-24 months of age.

Conclusions:

  • The study presents new, accurate reference ranges for plasma ionized calcium in pediatric patients.
  • A physiological rise in plasma ionized calcium post-birth followed by a decrease is confirmed.
  • These findings aid in the precise interpretation of ionized calcium levels in young children.
Abstract

Keywords:
calciumionized calciumnewbornspediatric laboratory medicinereference intervals

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