Relationship between ionized calcium and serum albumin level in children with idiopathic nephrotic syndrome
Abstract
Background Nephrotic syndrome (NS) patients frequently have abnormalities in calcium metabolism that manifest as hypocalcemia and reduced intestinal absorption of calcium. Hypocalcemia is initially attributed to hypoalbuminemia but it may also relate to a low level of ionized calcium. The ionized calcium level depends on the severity and duration of proteinuria.
Objective To assess the rel ationship between ionized calcium and serum albumin level in idiopathic NS children.
Methods An analytical study with cross-sectional design was applied to NS and healthy children between 1-14 years old in the Child Health Department of Hasan Sadikin Hospital, Bandung from December 2009 to April 2010. Ionized calcium was examined by Ca2 + analyzer AVL 980 with ion-selective electrodes (ISE) methods.
Results A total of34 subjects were recruited, consist of 17 NS and 17 healthy children. The mean ionized calcium and serum albumin level in NS children was 4.56 (SD 0.23) mg/dLand 1.45 (SD 0.24) g/dL, respectively. Statistical difference between ionized calcium level in NS and in healthy children was significant (P<0.05). Pearson correlation test between ionized calcium and serum albumin was significant (P<0.05) with correlation coefficient (r) 0.53. We found the following equation to estimate ionized calcium (y) based on the serum albumin level (x): y=3.84+0.49x.
Conclusion There is a moderately positive linear relationship between ionized calcium and serum albumin level in NS children.
References
2. Massry SG, Goldstein DA. Calsium metabolism in patients 'With nephrotic syndrome, a state 'With vitamin D deficiency.Am J Clin Nutr. 1978;31:1572•80.
3. Ponco E. Hubungan kadar kolesterol total dalam darah dengan frekuensi relaps pada anak dengan sindroma nefrotik di Bagian/SMF Hmu Kesehatan Anak/FKUP RS Hasan Sadikin kurun waktu 1995-1999. [thesis]. Bandung: Padjadjaran University, 1999.
4. Mizokuchi M, Kubota M, Tomino Y, Koide H. Possible mechanism of impaired calcium and vitamin D metabolism in nephrotic rats. Kidney Int. 1992;42:335-40.
5. Onifade KU, Mohammad AA, Petersen JR, Okorodudu AO. Ionized calcium: indications and advantages of its measurements. J Lab Med. 2005;29:235-40.
6. Choi DH, Chin DK, Lee JB, Kim PK. Calcium metabolism in nephrotic syndrome of children. Korean J Nephrol. 1987;6:311-9.
7. Bowers GN, Brassard C, Sena SF. Measurement of ionized calcium in serum 'With ionô€ selective electrodes: a mature technology that can meet the daily service needs. Clin Chem. 1986;32.1437-47.
8. Ria, Q, Iqbal A, Bhatty N, Mmaffar A, Rashid R. The effect of dietary habits on calcium level in nephrotic patients of pediatric population. J Agri Soc Sci. 2006;2:88-90.
9. Tryggvason K, Patrakka J, Wartiovaara J. Hereditary proteinuria syndrome and mechanism of proteinuria. N engl ) Med. 2006;354;1387:401.
10. Sekarwana N. Difference of lipid profile based on typesof nephrotic syndrome in children and correlation of lipid profile, Lp (A) 'With level of sV CAMô€ 1 as marker of atherosclerosis. MKI. 2006;56:525-31.
11. Fischbach FT. A manual of laooratory and diagnostic test. 7th Ed. Philadelphia: Lippincott Williams & Wilkins; 2003.
12. Hooft C, Vennassen A, Van Belle M. On calcaemia and phophataemia in the nephrotic syndrome. Comparative study of the periods before and after the introduction of hormone therapy. Helv Paediat Acta. 1960;15:437-50.
13. Amballi AA, Ogun SA, Odewabi AO. Hypoalbuminemia associated hypocalcemia 'With overt clinical features: a case report. SRE. 2010;5.1964-7.
14. Garniasih D. Hubungan an tara kadar albumin dan kalsium serum pada sindrom nefrotik anak. Sari Pediatri. 2008;10:100-5.
15. Colston K, Williams NJ, Cleeve HJW Studies on vitamin D binding protein in nephrotic syndrome. Clin Chem. 1985;31:718-21.
16. Guyton AC, Hall JE. Textbook of medical physiology. 11th ed. Philadelphia. Elsevier; 2005.
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
Accepted 2016-10-26
Published 2016-10-26