hypocalcemia.. a special prize to the winner

what causes this low calcium level???


A 61 yrs old male patient known to have impaired renal functions .....these are his laboratory investigations results

BUN 31 mg/dl (6-20mg/dl)
creat 3.7 mg/dl (0.6-1.3 mg/dl)
Na 134 mmol/l (135-148mmol/l)
K 2.6 mmol/l (3.5 -5.3mmol/l)
albumin 1.9 g/dl (3.5 - 5.0 g/dl)
calcium total 6.7mg/dl (8.6 - 10.3 mg/dl)
phosphorus 3.0 mg/dl (2.7-4.5 mg/dl)

don't forget the special prize to the winner

vit D is converted in the kidney from the inactive form to the active form

so when there is renal impairment ..... low vit. D

&

vit. D is responsible for Ca absorbtion

so low Ca level is the result

nice try
but
try again

Eman كتب:nice try
but
try again

oohhhhh noooo

itsn't right

nope
take a look on the investigations
why did i included them

امتي حنعرف الاجابة الصح ؟؟؟!!!

before commenting on total calcium levels, especially if obviously low
you must consider the albumin level and calculate corrected calcium level
Corrected calcium (mg/dL) = measured total Ca (mg/dL) + 0.8 (4.0 - serum albumin [g/dL]), where 4.0 represents the average albumin level in g/dL.

in other words, each 1 g/dL decrease of albumin will raise 0.8 mg/dL in serum Ca
it will be 8.4 mg/dl
you can notice that calcium levels
are much higher than we thought

so Ca level is normal
&
the cause of decrease is albumin

we need more