Calculation of Calcium Concentration

About 50% of the total calcium in the plasma is bound to plasma albumin, the rest calcium is in the physiologically active ionized free state. In cases where plasma albumin levels are low, total plasma calcium levels are often assessed with an adjustment for calcium binding to proteins. This methodology is quite common in clinical practice, however, a number of studies have raised doubts about the sufficient reliability and sensitivity of the relevant correction formulas. A more accurate assessment can be obtained by direct measurement of the ionized form of calcium, which is; the recommended method.

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The total plasma calcium level should be between 5-12 mg/dl (1.25-3 mmol/l)

Below are two formulas that are usually used to assess the level of total plasma calcium adjusted for plasma albumin content:

Total plasma calcium (adjusted) (mg/dl) = measured plasma calcium level (mg/dl) + 0.8*(4 - measured plasma albumin level (g/dl))
Total plasma calcium (adjusted) (mmol/l) = measured plasma calcium level (mmol/l) + 0.02*(40 - measured plasma albumin level (g/l))

Note: when drawing up formulas, the average albumin level is usually assumed to be 4g/dL (40g/L)

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Measured plasma calcium level
Measured plasma albumin level


Total plasma calcium (adjusted)		mg/dl

Calculation of Calcium Concentration

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