Use of Albumin-Adjusted Calcium Measurements in Clinical Practice
An erratum to this article was published (JAMA Netw Open, 3 Mar 2025 ↗)
Authors' conclusion
In this cross-sectional study drawn from a contemporaneous population, there appeared to be heavy reliance on adjustment formulas for calcium in clinical practice with little gain but considerable risk of misclassification of true calcium status, especially in the presence of hypoalbuminemia. These results suggest that unadjusted total calcium was the best and most practical alternative to ionized calcium.
Study context
- Population
- Adults tested for serum total and ionized calcium simultaneously, Alberta, Canada, 2013–2019; 52.5% female, median age 60 years
- Participants
- 22,658 adults
- Exposure
- Unadjusted vs albumin-adjusted total calcium (10 formulas), with ionized calcium as reference standard
- Outcome
- Correlation of unadjusted and adjusted total calcium (10 formulas) with ionized calcium, and association with classification of calcium status
Methodological detailspopulation-based
- Population-based
Main finding
As reported in the abstract
Observational data: associations, not effects.
Further findings
Agreement with ionized calcium in classifying hypocalcemia, normocalcemia or hypercalcemia
Agreement with ionized calcium in classifying hypocalcemia, normocalcemia or hypercalcemia
- Misclassification with adjustment formulas worse with hypoalbuminemia (albumin <30 g/L)
Original publication
Composed by AI from the published abstract and checked against it. How Briefs are made →