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calcium (Ca+2) in serum/plasma

Reference interval: - Male & Female: 8.1 - 10.9 mg/dL (serum) Clinical significance: - in the circulation Ca+2 is a) bound to protein (45%) b) in the free ionized form (45%) c) complexed to anions (10%) - albumin is the major serum protein binding Ca+2 - reference intervals for serum Ca+2 assume a normal serum albumin - a 'corrected' Ca+2 (for diminished albumin) may be estimated by the equation: Corrected Ca+2 = 0.8 x (4 - [serum albumin (g/dL)]) + serum Ca+2 - Ca+2 is the major mineral component of bone - 99% of the body's Ca+2 is in bone - plasma Ca+2 plays role in a) transmission of nerve impulses b) maintaining normal muscle contraction - abnormal concentrations of serum Ca+2 may indicate a) malfunction of the parathyroid glands b) bone diseases c) carcinoma d) malnutrition & (or) malabsorption syndrome e) vitamin D deficiency f) overdose with Ca+2-containing antacids g) renal diseases Increases: - see hypercalcemia - pharmaceutical agents: - in vivo effects - androgens, calciferol, dihyrotachysterol, progestins, estrogens, thiazides - calcium & vitamin D supplementation in postmenopausal women [11] Decreases: - see hypocalcemia - hypoalbuminemia - pharmaceutical agents: a) in vivo effects - acetazolamide, corticosteroids, mithramycin b) chemical interferences - citrate, EDTA Principle: The Kodak Ektachem Clinical Chemistry Slide (Ca) is a dry multilayered analytical element coated on a transparent polyester support. A 10 uL drop of sample deposited on the slide is evenly distributed on the reflective polymer spreading layer. The bound Ca+2 is dissociated from binding proteins, allowing the Ca+2 to penetrate through the spreading layer into the underlying dye- mordant layer. There, the Ca+2 forms a complex with Arsenazo III dye, causing a shift in the absorption maximum. The mordant binds with the dye, preventing migration into the spreading layer after the serum sample is deposited on the slide. After incubation, the reflection density of the colored complex is measured spectrophotometrically. The amount of colored complex formed is proportional to the amount of Ca+2 present in the sample. The following reaction sequences are involved: Ca2+ + Arsenazo III -----------> pH 5.6 colored Complex Specimen: Collect the specimen using standard venipuncture technique, without stasis, & remove promptly from the clot. Lithium or sodium heparin may be used as an anticoagulant for plasma specimens. Special Precautions: Do not use collection tubes containing fluoride, oxalate, citrate, or EDTA because these substances chelate Ca+2 causing significantly lower results. Prolonged contact with the clot may cause lowered Ca+2 values. Handle specimens in stoppered containers to avoid contamination and evaporation. Specimens must be allowed to reach room temperature prior to analysis. If possible, place at least 100 uL of sample in the sample cup & analyze within 15 minutes of filling the cup. Refrigerate samples at 2-8 degrees C for up to 24 hours. Minimum sample size of 0.5 milliliter with an optimum size of 1.0 milliliter or larger.

Related

Ca+2 calcium phosphate product (Ca-P product) hypercalcemia hypocalcemia ionized Ca+2 in serum/plasma/blood

Specific

calcium in serum post challenge

General

calcium in body fluid

References

  1. )Kodak Ektachem 700 Analyzer Operator's Manual, Kodak Clinical Products, Rochester, New York.
  2. Kodak Ektachem Slide Package Inserts, Kodak Clinical Products Rochester, New York.
  3. Kodak Ektachem Training Manual, Kodak Clinical Products,
  4. Clinical Diagnosis & Management by Laboratory Methods, 19th edition, J.B. Henry (ed), W.B. Saunders Co., Philadelphia, PA. 1996, pg 10.
  5. Calcium, Serum or Plasma Laboratory Test Directory ARUP: 20027
  6. Panel of 11 tests Laboratory Test Directory ARUP: 20144
  7. Panel of 9 tests Laboratory Test Directory ARUP: 20399
  8. Panel of 15 tests Laboratory Test Directory ARUP: 20408
  9. Mini Panel of 2 tests: Calcium for Parathyroid Hormone, Intact . Parathyroid Hormone, Intact Laboratory Test Directory ARUP: 70172
  10. Parathyroid Hormone, Intact Laboratory Test Directory ARUP: 70346
  11. Gallagher JC et al Incidence of hypercalciuria and hypercalcemia during vitamin D and calcium supplementation in older women. Menopause. June 16m 2014 PMID: 24937025 http://journals.lww.com/menopausejournal/Abstract/publishahead/Incidence_of_hypercalciuria_and_hypercalcemia.98368.aspx

Component-of

bone/joint panel calcium/albumin in serum/plasma calcium/phosphate in serum/plasma calcium/protein in serum/plasma calcium/sodium in serum/plasma chemistry 14 panel (comprehensive metabolic panel, CMP, chem 12, SMA12, SMA20) chemistry 8 panel (basic metabolic panel, BMP, basic chemistry panel) chemistry 8 panel with ionized calcium; basic metabolic panel (BMP) with ionized calcium chronic kidney disease panel coma panel pancreatic panel parathyroid panel