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[Total calcium or ionized calcium? A comparative study].

O Müller-Plathe, K Lindemann

    Deutsche Medizinische Wochenschrift (1946)
    |April 6, 1984
    PubMed
    Summary
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    Corrected ionized calcium (Ca2+corr) offers a practical method for diagnosing calcium metabolism disorders. This approach avoids difficult anaerobic sampling and provides more sensitive hypercalcemia detection than total calcium measurements.

    Area of Science:

    • Clinical Chemistry
    • Biochemistry
    • Calcium Metabolism

    Background:

    • Accurate measurement of ionized calcium is crucial for diagnosing calcium metabolism disorders.
    • Traditional methods for measuring ionized calcium require challenging anaerobic sampling.
    • Serum protein and albumin levels can interfere with total calcium measurements, affecting diagnostic accuracy.

    Purpose of the Study:

    • To evaluate a novel method for determining corrected ionized calcium (Ca2+corr) after CO2 equilibration.
    • To assess the practicality and diagnostic utility of Ca2+corr compared to total calcium.
    • To determine the sensitivity and specificity of Ca2+corr in diagnosing hypercalcemia.

    Main Methods:

    • Serum samples were equilibrated with CO2 to a standardized pH of 7.40.

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  • Ionized calcium was measured electronically after CO2 equilibration, yielding Ca2+corr.
  • Ca2+corr values were compared with total calcium measurements in a cohort of patients.

    • Main Results:

    • Ca2+corr obviates the need for "anaerobic" sampling required for direct ionized calcium measurement.
    • Protein or albumin concentration and complex-bound calcium do not interfere with Ca2+corr.
    • Ca2+corr demonstrated 2-3 times greater sensitivity for diagnosing hypercalcemia than total calcium.
    • Total calcium measurement showed unsatisfactory specificity, with 18-45% falsely reduced values when protein concentration was not considered.

    Conclusions:

    • Ca2+corr provides a practicable and reliable method for assessing calcium metabolism.
    • This method enhances the diagnosis of hypercalcemia by offering superior sensitivity and specificity compared to total calcium.
    • Ca2+corr simplifies calcium measurement by eliminating the need for specialized sampling techniques.