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Heparin effect on ionised calcium concentration

C K Biswas, J M Ramos, D N Kerr

    Clinica Chimica Acta; International Journal of Clinical Chemistry
    |November 11, 1981
    PubMed
    Summary
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    Heparin administration can significantly lower plasma ionised calcium levels. This effect was observed both in vitro and in vivo during haemodialysis, indicating a crucial consideration for clinical practice.

    Area of Science:

    • Biochemistry
    • Clinical Chemistry
    • Pharmacology

    Background:

    • Heparin is a widely used anticoagulant.
    • The potential impact of heparin on electrolyte balance, specifically ionised calcium, requires thorough investigation.
    • Accurate measurement of ionised calcium is critical in various clinical settings.

    Purpose of the Study:

    • To investigate the effect of heparin on plasma ionised calcium levels.
    • To determine the dose-dependent relationship between heparin concentration and ionised calcium reduction.
    • To assess the in vivo effect of heparinisation on ionised calcium during haemodialysis.

    Main Methods:

    • In vitro addition of increasing heparin concentrations (1-2 U/ml) to whole blood from healthy subjects.
    • In vivo study involving intravenous injection of 10,000 U heparin in patients undergoing haemodialysis.

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  • Measurement of plasma ionised calcium levels before and after heparin administration.

    • Main Results:

    • In vitro: No significant change at 1 U/ml, but a significant fall of 0.02 mmol/l at 2 U/ml, with further decreases at higher concentrations.
    • Heparin from different manufacturers yielded similar results.
    • In vivo: A consistent and significant average fall of 0.03 mmol/l in ionised calcium was observed during haemodialysis.

    Conclusions:

    • Heparin causes a dose-dependent decrease in plasma ionised calcium.
    • The observed hypocalcaemic effect of heparin is clinically relevant, particularly in patients undergoing procedures like haemodialysis.
    • Monitoring of ionised calcium levels may be warranted in patients receiving heparin, especially those with renal impairment.