Calcium Correction for Hypoalbuminemia and Hyperalbuminemia

Consider measuring ionized calcium to confirm conclusions drawn after correcting for serum calcium.

• If calcium is confirmed to be outside of normal range, consider a diagnostic evaluation to determine the etiology.

Common causes of Hypocalcemia:

• • Vitamin D inadequacy or resistance.

  • Hypoparathyroidism.

  • Renal disease or end-stage liver disease causing vitamin D inadequacy.

  • Malabsorption.

  • Post-gastric bypass surgery.

  • Drugs and toxic ingestions.

  • Hypomagnesemia.

Common Causes of Hypercalcemia:

• • Primary hyperparathyroidism.

  • Vitamin D toxicity.

  • Vitamin A toxicity.

  • Cancer.

  • Sarcoidosis.

  • Medications (e.g. lithium and thiazide diuretics).

  • Dehydration or volume depletion.

  • Genetic conditions (e.g. familial hypocalciuric hypercalcemia).

  • Little or no movement.