INTRODUCTION
1.1 INTRODUCTION
Calcium is the largest mineral in the human body, where it plays an important role in absorption and the releasing of calcium in the body is through the intestinal and kidney. The calcium in the body is controlled by hormones and vitamins (Takano et al). The three major components that involve in the controller the calcium is parathyroid hormone (PTH), calcitonin and Vitamin D. The consistent the calcium in the body from despite variation in-take and excretion also need help by others hormones to balance the homeostasis of calcium (Caprita, Caprita, & Cretescu, 2013).
Calcium in a human body can be found in three distinct fractions which are related to one and another as an ionized or free calcium, the complex calcium and non-diffusible calcium where the calcium bound to plasma protein (Wills, Lewin, & Hospital, 1971). The level of calcium is closely regulated by the normal total calcium and normal ionized calcium. The total amount of calcium in the body varies with the level of serum albumin, a protein to bind with calcium.
A biological effect of calcium is measured by the amount of ionized calcium, total calcium. The calcium is not a dependent parameter. Calcium is a measurement of the …show more content…
serum albumin where is bound with the amount of calcium without altering the biological significance of ionized calcium. There are many methods are used to adjust the calcium concentration which is based on the results of albumin. It also has a different method which many laboratories report the result using own equation or formula calculated the adjustment of calcium. Although the measurement of total calcium, albumin, and total protein can be analysed in most laboratory, measurement of ionized calcium remains as a reference even there has difficulty to maintain the performance. (Clase, Norman, Beecroft, & Churchill, 2000).
Patients diagnosed with kidney disease caused by glomerular failure often have altered concentrations of calcium, phosphate, albumin, magnesium and pH.
Since conditions tend to change ionized calcium independently of total calcium, ionized calcium is one of the preferred methods of calcium binding to albumin. In this case, the measurement of ionized calcium referred to detect hypocalcaemia (Hannan & Thakker, 2013). The first step to assess patients with hypocalcaemia is the measurement of the concentration of serum albumin. Where the calcium is bound to proteins, primarily albumin, therefore total calcium concentrations in patients with low levels of serum albumin or higher may not be appropriate for measured the ionized
calcium.