Correlation Between Serum Albumin Level and Ionized Calcium in Idiopathic Nephrotic Syndrome in Children

Abstract

Background: Nephrotic syndrome frequently have abnormalities in calcium metabolism that manifest as hypocalcaemia. The serum ionized calcium level depends on the severity and duration of proteinuria. Methods:The aim of this study was to assess the correlation between serum albumin level and ionized calcium in children with idiopathic nephrotic syndrome. An analytic study with cross sectional comparative design was applied to nephrotic syndrome and healthy children between 2-8 years old in the Department of Pediatric Nephrlology, Comilla Medical College Hospital. A total of 120 subjects were recruited, 60 nephrotic syndrome as cases and 60 healthy children as controls. The mean serum albumin and serum ionized calcium levels of cases and controls were estimated respectively. Pearson's correlation test was done to see the correlation. Results:Mean serum albumin level of cases and controls were 1.98±0.38 g/dl and 4.57±0.25 g/dl, respectively (p<.001) and mean serum ionized calcium of cases and controls were 1.13±0.08 mmol/L and 2.34±0.05 mmol/L respectively (p<.001). Pearson's correlation test between serum albumin and serum ionized calcium level of cases were significant (P<0.05). Conclusion:There was a positive correlation between serum albumin level and ionized calcium in idiopathic nephrotic syndrome, that is lower the serum albumin level, the lower will be the serum ionized calcium and higher the albumin level, higher will be calcium level.

Correlation between corrected serum calcium and serum albumin in children with idiopathic nephrotic syndrome in North central, Nigeria

“…21 Viola et al had also reported in their study that although the ionized calcium levels in the cases were lower than that found in the healthy controls, some of the cases in their study also had normal ionized calcium. 15 The duration of proteinuria in their cases ranged from 7 days to 2 months and they attributed the normal ionized calcium levels to the shorter duration of proteiniuria in those cases. In our study, the duration of hypoalbuminaemia in all the cases was not long as they had all presented to the hospital within two days to two weeks of developing symptoms.…”

“…Our finding of lower serum albumin and serum calcium in the cases compared to healthy controls is the trend in reports of previous researchers who reported on the serum albumin and calcium in patients with nephrotic syndrome. 12,15,16 Abnormalities of calcium metabolism resulting in hypocalcaemia are well documented in nephrotic syndrome. [14][15][16][17][18] Although there are several causes of hypocalcaemia in nephrotic syndrome, the foremost cause is hypoalbuminaemia.…”

“…12,15,16 Abnormalities of calcium metabolism resulting in hypocalcaemia are well documented in nephrotic syndrome. [14][15][16][17][18] Although there are several causes of hypocalcaemia in nephrotic syndrome, the foremost cause is hypoalbuminaemia. This is based on the important hypothesis that a decrease in albumin leads to a decrease in the albumin-bound calcium fraction which leads to a decrease in total calcium while ionized calcium levels remain normal and such patients remain asymptomatic.…”

“…13,14 Previous researchers have reported a positive correlation between serum albumin and ionized calcium in children with idiopathic nephrotic syndrome. 15,16 Despite the fact that total calcium is still more conventionally measured, several of the research carried out has focused on the correlation between ionized calcium and albumin and not on the relationship between total or corrected serum calcium and albumin. 11,16,17 These previous studies reported positive correlations between serum ionized calcium and serum albumin.…”

A Nuisance-Free Inference Procedure Accounting for the Unknown Missingness with Application to Electronic Health Records

“…We aim to apply the proposed method to the study of the albumin level ( Y ). The calcium level in the blood sample, free of missing data, has been shown in the biomedical literature that it has high correlation with the albumin level [ 30 , 31 , 32 ]; therefore, we adopt the calcium level as the shadow variable Z . Seventeen other variables comprise the vector , which are either demographics (age and gender), chart events (respiratory rate, glucose, heart rate, systolic blood pressure, diastolic blood pressure, and temperature), other laboratory tests (urea nitrogen, platelets, magnesium, hematocrit, red blood cell, white blood cell, and peripheral capillary oxygen saturation (SpO2)), or aggregated metrics (simplified acute physiology score (SAPS-II) and sequential organ failure assessment score (SOFA)).…”