ArticleZeitschrift fur Gerontologie und Geriatrie2026
Adjustment of total plasma calcium for albumin concentrations avoids overdiagnosis of hypocalcemia in geriatric patients.
Article in Zeitschrift fur Gerontologie und Geriatrie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundCalcium is critically involved in bone metabolism and stability, nerve excitability and intercellular signal transduction.
methodsIn this retrospective study, calcium plasma concentrations of all patients treated in 2018 at our institution were evaluated. As approximately 50% of the plasma calcium is bound to plasma proteins, in particular albumin, additionally the respective plasma albumin concentration was determined and the albumin-corrected calcium plasma concentration was estimated.
resultsIn 1246 of 1721 cases the plasma calcium concentration on admission was normal (2.15-2.55 mmol/l), in 421 cases hypocalcemia (< 2.15 mmol/l) and in 38 cases hypercalcemia (> 2.55 mmol/l) were detected. In 1226 of 1543 cases (79.5%) hypoalbuminemia was noted. After correction of the plasma calcium levels for plasma albumin by the modified Payne equation, the corrected plasma calcium was normal in 1272 cases (73.9%), decreased in 15 cases (0.9%), and elevated in 256 cases (14.9%). The frequency of hypercalcemia > 2.8 mmol/l requiring rapid clinical interventions without correction for plasma albumin was 6 of 1705 patients (0.4%), after correction for albumin 24 of 1543 patients (1.6%). In logistic regression analysis, higher albumin was strongly associated with a decreased mortality (odds ratio, OR = 0.88, 95% confidence interval, CI 0.83-0.94, p < 0.001), whereas the plasma calcium concentration had no independent influence on mortality.
conclusionWithout correction for plasma albumin, approximately 25% of the patients were hypocalcemic on admission. After correction for plasma albumin, this rate fell to < 1%. We suggest that the determination of plasma albumin should be included in the clinical routine on admission in all geriatric patients.
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