scholarly journals Serum calcium measurement: Total versus free (ionized) calcium

2005 ◽  
Vol 20 (2) ◽  
pp. 158-161 ◽  
Author(s):  
Laxmayya Sava ◽  
Sandhya Pillai ◽  
Umesh More ◽  
Alka Sontakke
Keyword(s):  
Serum Calcium ◽  
Ionized Calcium ◽  
Calcium Measurement

Calculated serum calcium is an insufficient surrogate for measured ionized calcium

2009 ◽  
Vol 49 (3) ◽  
pp. 348-350 ◽  
Author(s):  
Mikko P. Björkman ◽  
Antti J. Sorva ◽  
Reijo S. Tilvis
Keyword(s):  
Serum Calcium ◽  
Ionized Calcium

scholarly journals Association of dietary calcium intake, total and ionized serum calcium levels with preeclampsia in Ethiopia

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rahel D. Gebreyohannes ◽  
Ahmed Abdella ◽  
Wondimu Ayele ◽  
Ahizechukwu C. Eke
Keyword(s):  
Serum Calcium ◽  
Calcium Intake ◽  
Calcium Level ◽  
Serum Calcium Level ◽  
Dietary Calcium ◽  
Ionized Calcium ◽  
Dietary Calcium Intake ◽  
Total Serum ◽  
Total Serum Calcium ◽  
Total Serum Calcium Level

Abstract Background Preeclampsia is a well-known cause of maternal mortality and morbidity in Ethiopia. The exact pathophysiology has not been fully understood. Calcium and magnesium deficiencies have been given emphasis to play roles in the pathophysiology. Although evidence is abundant, they are equivocal. The study aimed to see the association of dietary calcium intake, serum total calcium level and ionized calcium level with preeclampsia. It also evaluated the association between dietary calcium intake and serum calcium levels. Materials and methods An unmatched case–control study was conducted in Gandhi Memorial, Tikur Anbessa, and Zewditu Memorial Hospitals, all in Addis Ababa, between October to December, 2019. Cases were 42 women with preeclampsia and controls were 42 normotensive women. The medical and obstetric history was gathered using a structured questionnaire and the dietary calcium intake information using a 24-h dietary recall. The serum levels of total serum calcium and ionized (free) calcium were measured using an inductively coupled mass spectrophotometer. Bivariate and multivariate logistic regression and Pearson correlation test were utilized during data analysis. Results In comparison with controls, women with preeclampsia had lower mean (± 1SD) levels of ionized calcium level (1.1 mmol/l ± 0.11), total serum calcium level (1.99 mmol/l ± 0.35) and lower median (IQR) dietary calcium intake (704 mg/24 h,458–1183). The odds of having preeclampsia was almost eight times greater in those participants with low serum ionized calcium level (OR 7.5, 95% CI 2.388–23.608) and three times higher in those with low total serum calcium level (OR 3.0, 95% CI 1.024–9.370). Low dietary calcium intake also showed statistically significant association with preeclampsia (OR 3.4, 95% CI 1.092 -10.723). Serum ionized calcium level and total serum calcium level showed positive correlation of moderate strength (p = 0.004, r = 0.307), but no correlation was found between dietary calcium intake with both forms of serum calcium levels. Conclusion This study showed significant association between low dietary calcium intake and low serum calcium levels with preeclampsia, hence this can be used as a supportive local evidence for the current context-specific recommendation of calcium supplementation in societies with low-dietary calcium consumption in an attempt to prevent preeclampsia, therefore implementation study should be considered in Ethiopia to look for the feasibility of routine supplementation.

Effect of Hypocalcemia on Cardiac Function in Very-Low-Birth-Weight Preterm Neonates: Studies of Blood Ionized Calcium, Echocardiography, and Cardiac Effect of Intravenous Calcium Therapy

PEDIATRICS ◽  
1985 ◽  
Vol 76 (4) ◽  
pp. 543-550
Author(s):  
Pankaja S. Venkataraman ◽  
Don A. Wilson ◽  
Roger E. Sheldon ◽  
Radhakrishna Rao ◽  
Michael K. Parker
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Cardiac Function ◽  
Serum Calcium ◽  
Calcium Concentration ◽  
Very Low Birth Weight ◽  
Left Ventricular ◽  
Ionized Calcium ◽  
Total Calcium ◽  
Serum Total Calcium

Traditionally, in infants, a serum calcium value less than 7.0 mg/dL is considered to impair cardiac function. In very-low-birth-weight infants, we studied the hypotheses that decline in serum calcium to 6.0 mg/dL (1) would not impair cardiac function and (2) ionized calcium would remain greater than 3.0 mg/dL. We also evaluated the effect of calcium infusion on cardiac function. We studied 15 normokalemic and normonatremic infants whose birth weights were 822 to 1,450 g and were less than 32 weeks' gestation. When serum calcium declined to less than 6.0 mg/dL, 18 mg/kg of calcium as 5% calcium gluconate was infused for 10 minutes. Serum total calcium concentration, blood ionized calcium concentration, ECG, and M-mode echocardiogram were obtained on entry into the study, when the infants were hypocalcemic, immediately after treatment with calcium, and eight hours after treatment. Ionized calcium values were calculated based on serum total calcium and serum protein, and corrected calcium values were calculated based on serum total calcium, serum albumin, and blood pH. In all infants, serum calcium value declined to less than 7.0 and in eight infants to less than 6.0 mg/dL. Assessment of heart rate, systolic blood pressure, ejection fraction, left ventricular systolic time interval, right ventricular systolic time interval, fiber shortening index, and left ventricular mean velocity of circumferential fiber shortening showed no significant alteration from baseline during hypocalcemia or in association with intravenous slow bolus infusion of 18 mg/kg of calcium. In association with a decline in serum total calcium to as low as 6.0 mg/dL, whole blood ionized calcium was maintained at more than 3.0 mg/dL. Serum total calcium and calculated ionized calcium values correlated significantly with measured blood ionized calcium concentrations; however, these measures were not reliable predictors of blood ionized calcium. We speculate that the hypoproteinemia and hypoalbuminemia noted in these infants may result in relative protection of the blood ionized calcium in these infants. We suggest that in neonates with wide ranges in gestation, serum protein, and blood pH levels, total serum calcium and calculated ionized calcium values may be poor measures of derangement of calcium metabolism. Decline in total serum calcium concentration to 6.0 mg/dL was not associated with impaired cardiac function, and slow bolus calcium infusion in these hypocalcemic very-low-birth-weight infants neither improved nor impaired cardiac function.

scholarly journals VITAMIN D DEFICIENCY AND PARATOHOMMONIUM INCREASE IN LATE POSTOPERATIVE GASTRIC BYPASS IN ROUX-EN-Y

2018 ◽  
Vol 31 (4) ◽  
Author(s):  
Daniela Vicinansa MÔNACO-FERREIRA ◽  
Vânia Aparecida LEANDRO-MERHI ◽  
Nilton César ARANHA ◽  
Andre BRANDALISE ◽  
Nelson Ary BRANDALISE
Keyword(s):  
Vitamin D ◽  
Gastric Bypass ◽  
Secondary Hyperparathyroidism ◽  
Vitamin D Deficiency ◽  
Serum Calcium ◽  
Calcium Metabolism ◽  
Calcium Deficiency ◽  
Ionized Calcium ◽  
Nutritional Deficiencies ◽  
Biochemical Tests

ABSTRACT Background : Roux-en-Y gastric bypass patients can experience changes in calcium metabolism and hyperparathyroidism secondary to vitamin D deficiency. Aim : To evaluate nutritional deficiencies related to the calcium metabolism of patients undergoing gastric bypass with a 10-year follow-up. Method : This is a longitudinal retrospective study of patients submitted to Roux-en-Y gastric bypass at a multidisciplinary clinic located in the Brazilian southeast region. The study investigated the results of the following biochemical tests: serum calcium, ionized calcium, vitamin D, and parathormone (PTH). The generalized estimating equations (GEE) determined the nutritional deficiencies using a significance level of 5%. Results : Among the patients who finished the study (120 months), 82.86% (n=29) had vitamin D deficiency, and 41.94% (n=13) had high PTH. Postoperative time had a significant effect on PTH (p=0.0059). The percentages of patients with vitamin D, serum calcium, and ionized calcium deficiencies did not change significantly over time. Conclusion : One of the outcomes was vitamin D deficiency associated with secondary hyperparathyroidism. These findings reaffirm the importance of monitoring the bone metabolism of patients submitted to Roux-en-Y gastric bypass. HEADINGS: Calcium deficiency. Vitamin D deficiency. Secondary hyperparathyroidism.

Optimal Discrimination of Mild Hyperparathyroidism with Total Serum Calcium, Ionized Calcium and Parathyroid Hormone Measurements

1987 ◽  
Vol 92 (2) ◽  
pp. 147-176 ◽  
Author(s):  
Lars Benson ◽  
Sverker Ljunghall ◽  
Torgny Groth ◽  
Hans Falk ◽  
Andreas Hvarfner ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Serum Calcium ◽  
Ionized Calcium ◽  
Total Serum ◽  
Total Serum Calcium

scholarly journals Reducing Routine Ionized Calcium Measurement

2009 ◽  
Vol 55 (3) ◽  
pp. 533-540 ◽  
Author(s):  
Geoffrey S Baird ◽  
Petrie M Rainey ◽  
Mark Wener ◽  
Wayne Chandler
Keyword(s):  
Calcium Supplementation ◽  
Reference Interval ◽  
Ionized Calcium ◽  
Total Calcium ◽  
Calcium Treatment ◽  
Testing Strategy ◽  
Substantial Fraction ◽  
Oral Calcium ◽  
Testing Frequency ◽  
Calcium Measurement

Abstract Background: Ionized calcium (iCa) is measured frequently in hospitalized patients, and hypocalcemia is frequently found, seemingly supporting the practice. Methods: We retrieved the results of 58 040 iCa tests and records of intravenous (IV) and oral calcium supplementation from laboratory and hospital information systems and evaluated them for frequency of testing, frequency of hypocalcemia, and effects of calcium supplementation. Results: Serial and daily iCa testing was common and responsible for a substantial fraction of all iCa tests ordered. Half of all patients tested had iCa values below the reference interval. IV, but not oral, calcium therapy increased mean iCa concentrations, but the effect of calcium administration was small compared with the spontaneous increase in iCa that occurred in similar patients who received no calcium treatment. A retrospective analysis suggested that a low total calcium (tCa) concentration (<2.00 mmol/L, <8 mg/dL) could identify most patients with low iCa (<1.0 mmol/L). Introduction of a reflexive strategy reduced iCa testing by 72%–76% and reduced IV calcium gluconate therapy by 45%–81%. Conclusions: Testing for iCa and IV calcium supplementation were significantly reduced with a reflexive calcium testing strategy that provided iCa testing only to patients with low tCa. Adverse clinical outcomes possibly associated with hypocalcemia did not increase.

scholarly journals Parathyroid Hormone Disturbances in Postmenopausal Women with Distal Forearm Fracture

2021 ◽  
Author(s):  
Axel Wihlborg ◽  
Karin Bergström ◽  
Paul Gerdhem ◽  
Ingrid Bergström
Keyword(s):  
Parathyroid Hormone ◽  
Adverse Effects ◽  
Postmenopausal Women ◽  
Serum Calcium ◽  
Forearm Fracture ◽  
Ionized Calcium ◽  
Distal Forearm ◽  
Distal Forearm Fracture ◽  
Population Prevalence ◽  
Wide Range

Abstract Background Primary hyperparathyroidism (PHPT) is a common endocrine disorder with a wide range of adverse effects, such as osteoporosis. Many women are not diagnosed due to asymptomatic disease or vague symptoms but are still at risk of severe adverse effects. Early identification of patients with PHPT is therefore of importance. The aim of this study was to determine PHPT prevalence among postmenopausal women with a distal forearm fracture. Methods Recruitment was conducted in conjunction with the occurrence of a distal forearm fracture at Karolinska University Hospital. In total, 161 postmenopausal women were included in a cross-sectional study with repeated evaluations. Analyzes of serum calcium, ionized calcium, phosphate, parathyroid hormone (PTH), and vitamin D were performed. Diagnosis of PHPT was based on clinical evaluations and biochemical definitions of serum calcium and PTH in coherence with previous population prevalence reports. Results Mean age was 64.7 (9.5) years, serum calcium 2.33 (0.10) mmol/L, ionized calcium 1.25 (0.05) mmol/L and PTH 54 (26) ng/L. PTH was elevated in 32 (20%) women. In total, 11 (6.8%) women were diagnosed with PHPT; 6 with classical PHPT and 5 with mild PHPT. The prevalence of PHPT was significantly increased compared to the population prevalence of 3.4% (p = 0.022). Conclusion Screening postmenopausal women in conjunction with low-energy distal forearm fracture revealed a large number of women with parathyroid disturbance. Evaluation of parathyroid hormone and calcium status in this group of patients seems beneficial.

scholarly journals Study of the incidence of hypocalcemia in patients undergoing bilateral thyroid surgery

2020 ◽  
Vol 7 (9) ◽  
pp. 2914
Author(s):  
Baleshwar Dhiman ◽  
Satish Dalal ◽  
Nityasha Dalal ◽  
Sethu Raman
Keyword(s):  
Serum Calcium ◽  
Thyroid Surgery ◽  
Thyroid Disease ◽  
Study Data ◽  
P Value ◽  
Chi Square ◽  
Ethical Approval ◽  
Chi Square Test ◽  
Calcium Measurement ◽  
Benign Thyroid

Background: Thyroid surgery are among the most common operations performed all over the world. Hypocalcemia following total thyroidectomy is a fairly common complication. Occurrence of acute hypocalcemia can be predicted in patients undergoing thyroid surgery, based on serial calcium measurement and this helps in early prediction of hypocalcemia. The aim of present study was to assess the incidence of post thyroidectomy hypocalcemia and factors which might play a role in its occurrence.Methods: A total 30 patients who underwent bilateral thyroidectomy were analysed. The study period was from June 2017 to March 2019. The incidence of hypocalcemia was analysed with serial calcium estimation in immediate post-operative period, 4 hours and 24 hours after surgery and on 5th post-operative day. The factors analysed included pre-operative and post-operative serum calcium levels, clinical features, the disease type and factors related to surgery. The ethical approval was taken from the ethical committee of the institute. At the end of the study data was collected and analysed by using student t-test and chi square test. A p-value of less than 0.05 was considered significant.Results: Post-operative transient hypocalcemia developed in 21 patients out of 30 (70%). Of them six patients (28.75%) developed severe hypocalcemia and 15 (71.42%) developed mild to moderate hypocalcemia. Out of six patients, five patients were histopathologically diagnosed as malignant thyroid disease. 15 patients who developed mild to moderate hypocalcemia were diagnosed to be having benign thyroid conditions.Conclusions: Patients underwent thyroid surgery for malignant conditions showed higher incidence and severity hypocalcemia as compared to cases where surgery was performed for benign thyroid disease. This complication can be prevented with meticulous perioperative dissection, prompt identification of parathyroid glands and frequent postoperative monitoring of serum calcium levels.

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