ArticleJAMA network open2025
Use of Albumin-Adjusted Calcium Measurements in Clinical Practice.
Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 30 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed.
- Multiple electrolyte imbalances in hospitalized patients: a multimorbidity perspective from a large, retrospective cohort study.Annals of medicine · 2026Article
- Clinical Relevance of Calcium Measures: QT-Based Comparison of Ionized, Total, and Albumin-Corrected Calcium.Kidney360 · 2026Observational
- Clinical Anterior Segment and Ocular Surface Findings Across Renal Replacement Modalities: Associations with CKD-Related Factors, Mineral Metabolism and Activin A.Life (Basel, Switzerland) · 2026Article
- Are Routine Labs Necessary? Postoperative Electrolyte Trends in Lipedema Patients Undergoing Liposuction: Insights from a Single-Center Retrospective Cohort.Aesthetic plastic surgery · 2026Article
- A blood-draw timing- and season-adjusted PTH-calcium model for predicting post-endoscopic/robotic thyroidectomy hypocalcemia.Endocrine connections · 2026Article
- Management of Chronic Hypoparathyroidism and Hyperparathyroidism in Pregnancy/Lactation.Current osteoporosis reports · 2026Review
- Extreme PTH-Independent Hypercalcemia Mediated by a Rare Non-Osteoclastic Osteolysis Mechanism in Newly Diagnosed High-Risk Biclonal IgA Multiple Myeloma: Temporal Association with the Second Dose of Moderna mRNA-1273 COVID-19 Vaccine.International journal of molecular sciences · 2026Article
- Retinal Structural and Microvascular Findings on OCT and OCTA in Hemodialysis and Kidney Transplant Recipients and Their Association with Mineral Metabolism Parameters.Medical sciences (Basel, Switzerland) · 2026Article
- Review
- Electrolyte-derived clinical indices in traumatic brain injury: A narrative review.World journal of methodology · 2026Review
- Intraoperative PTH monitoring: does sampling site or assay generation matter?Journal of the Endocrine Society · 2026Article
- Correlation and dissociation factors between ionized, total, and corrected calcium in patients undergoing hemodialysis.Clinical and experimental nephrology · 2026Article
- Interpretation of serum magnesium concentrations in the presence of the systemic inflammatory response: a large patient cohort study.Scientific reports · 2026Article
- Admission Electrolyte Abnormalities and Clinical Outcomes in Hospitalized COVID-19 Patients.Medicina (Kaunas, Lithuania) · 2026Article
- Parenteral dextrose during refeeding is associated with electrolyte deficiencies in anorexia nervosa: a route-specific analysis of oral and parenteral nutrition.Journal of eating disorders · 2026Article
- A Universal Framework for Blood Ionome Extraction and Intelligent Quality Control inAnalytical chemistry · 2026Article
- Albumin-corrected tCa/iCa ratio: are we still diagnosing citrate accumulation or predicting mortality?Critical care (London, England) · 2026Article
- Markers of Mineral Metabolism in Children With CKD Stages 2 to 5D.Kidney international reports · 2026Article
- Adjustment of total plasma calcium for albumin concentrations avoids overdiagnosis of hypocalcemia in geriatric patients.Zeitschrift fur Gerontologie und Geriatrie · 2026Article
- Study of a Kawasaki disease diagnostic prediction model based on the LightGBM machine learning algorithm.Frontiers in artificial intelligence · 2026Article
Corrections and comments
- Erratum issued
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Using albumin-adjusted calcium is commonly recommended for for measuring calcium, but with little empirical evidence to support the practice. Objective: To assess the correlation between total calcium measurements (with or without adjustment) vs the ionized calcium level as a reference standard. Design, Setting, and Participants: This was a population-based cross-sectional study in the province of Alberta, Canada, including adults tested for serum total calcium and ionized calcium simultaneously between January 1, 2013, and October 31, 2019. Statistical analysis was performed from March 2023 to October 2024. Main Measures and Outcomes: The correlation between unadjusted and adjusted total calcium measurements (using 10 formulas) and the ionized calcium level was evaluated, along with the potential association with the classification of calcium status. Results: Among 22 658 patients included, 11 889 (52.5%) were female and 10 769 (47.5%) were male; the median (IQR) age was 60 (47-72) years. The unadjusted total calcium (R2 = 71.7%; 95% CI, 71.1%-72.2%) had a stronger correlation with ionized calcium than the commonly used simplified Payne formula (ie, total calcium [mmol/L] + 0.02 [40 - albumin (g/L)]) (R2 = 68.9%; 95% CI, 68.0%-69.6%) and correlated similarly to other formulas (Payne: lowest R2 = 60.3%; 95% CI, 59.3%-61.3%; and James: highest R2 = 76.7%; 95% CI, 76.1%-77.3%). When classifying patients into categories of hypocalcemia, normocalcemia, or hypercalcemia, unadjusted total calcium had the best overall agreement (74.5%) with ionized calcium compared with albumin-adjusted calcium using the original Payne and simplified Payne formulas (agreement 63.0% and 58.7%, respectively). Misclassification using the adjustment formulas was worse in the presence of hypoalbuminemia (albumin level <30 g/L). Conclusions and Relevance: 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.
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