Serum intact parathyroid hormone and ionised calcium concentration in children with renal insufficiency

Fractionation of calcium and magnesium in equine serum

OBJECTIVE

To establish reference values for protein-bound, ionized, and weak-acid complexed fractions of calcium and magnesium in equine serum and determine stability of ionized calcium (iCa) and ionized magnesium (iMg) in serum samples kept under various storage conditions.

ANIMALS

28 clinically normal horses.

PROCEDURE

Total calcium (tCa) and magnesium (tMg) in equine serum were fractionated by use of a micropartition system that allows separation of protein-bound calcium (pCa) and magnesium (pMg) and ultrafiltrable calcium (microCa) and magnesium (microMg) fractions. Serum concentrations of iCa and iMg were measured in the ultrafiltrate by use of selective electrodes. Serum concentration of complexed calcium (cCa) or magnesium (cMg) was calculated by subtracting iCa or iMg from microCa or microMg, respectively.

RESULTS

Mean +/-SE serum tCa concentration was 3.26 +/- 0.06 mmol/L. Calcium fractions were as follows: pCa, 1.55 +/- 0.03 mmol/L (47.4 +/- 0.9%); iCa, 1.58 +/- 0.03 mmol/L (48.5 +/- 0.7%); and cCa, 0.13 +/- 0.02 mmol/L (4.1 +/- 0.9%). Serum tMg concentration was 0.99 +/- 0.04 mmol/L. Magnesium fractions were as follows: pMg, 0.33 +/- 0.04 mmol/L (33.3 +/- 4.2%); iMg, 0.57 +/- 0.02 mmol/L (57.6 +/- 1.7%); and cMg, 0.09 +/- 0.02 mmol/L (9.1 +/- 1.9%). Refrigeration (4 degrees C) did not affect iCa values, whereas iMg declined by 8% after 120 hours. Neither iCa nor iMg was affected by freezing (-20 degrees C).

CONCLUSIONS AND CLINICAL RELEVANCE

In equine serum, iMg is less stable than iCa; thus, when serum samples are not going to be analyzed promptly, freezing may be preferable to refrigeration for storage.

Determination of calcium fractionation in dogs with chronic renal failure

OBJECTIVE

To determine concentrations of calcium (total [tCa], ionized [iCa], protein-bound [pCa], and complexed [cCa]) in dogs with chronic renal failure (CRF).

ANIMALS

23 dogs with CRF.

PROCEDURE

Serum calcium was fractionated by use of a micropartition system. Total calcium and iCa concentrations and pH were measured in unfractionated serum, and tCa concentration was measured in the ultrafiltrate. The pCa fraction was calculated by subtracting tCa of the ultrafiltrate from tCa concentration of unfractionated serum. The iCa concentration in unfractionated serum was subtracted from tCa concentration in the ultrafiltrate to determine the concentration of cCa.

RESULTS

Concentrations of tCa, iCa, pCa, and cCa had wide ranges among dogs with CRF Dogs with significantly low tCa concentration (770 +/- 1.73 mg/dL) had cCa concentration (0.76 +/- 0.38 mg/dL) within reference range, whereas dogs with reference range to high tCa concentration (10.85 +/- 1.13 mg/dL) had significantly high cCa concentration (2.62 +/- 1.04 mg/dL). There was no significant difference in iCa or pCa concentrations between groups.

CONCLUSIONS AND CLINICAL RELEVANCE

Concentrations of tCa, iCa, cCa, and pCa varied widely in dogs with CRF Overall, cCa concentration was high, although subpopulations differed in cCa and tCa concentrations. Differences in tCa concentration were primarily attributable to differences in cCa fraction.