For patients with decreased calcium levels, what should be considered regarding albumin?

In the context of decreased calcium levels, understanding the relationship between calcium and albumin is crucial. Calcium in the blood circulates in two forms: free (ionized) calcium and protein-bound calcium, primarily to albumin. When serum albumin levels decrease, there is typically a corresponding decrease in the total calcium level measured, even if the ionized calcium (which is the biologically active form) may remain relatively stable.

This phenomenon occurs because total calcium levels are influenced by the amount of calcium that is bound to proteins such as albumin. Therefore, when albumin levels drop, the total calcium measurement reflects that reduction, which can lead to misinterpretation of a patient's calcium status if not adjusted for albumin levels. Understanding this relationship is essential in clinical practice, as treating a low total calcium level without considering albumin levels may not address the underlying issue.

In cases of low serum albumin, it's important to interpret total calcium values cautiously and consider performing a corrected calcium calculation to better assess the patient's true calcium status. This highlights the significance of the interaction between calcium and albumin and why a decrease in albumin can lead to an apparent decrease in calcium levels.