Renal / Nephrology General Medicine Endocrinology Standard clinical practice

Corrected Calcium

Adjusts serum calcium for albumin level to obtain true calcium status.

Score interpretation

Hypocalcaemia 0–2.19

Corrected Ca²⁺ < 2.2 mmol/L: Hypocalcaemia.

→ Mild (2.0–2.2): Oral calcium supplements + vitamin D. Severe (<1.9) / symptomatic: IV calcium gluconate 10% 10ml over 10 min. Check PTH, vitamin D, phosphate, Mg²⁺.

Normal 2.2–2.6

Corrected Ca²⁺ 2.2–2.6 mmol/L: Normal range.

→ No acute intervention required.

Mild Hypercalcaemia 2.61–3

Corrected Ca²⁺ 2.6–3.0 mmol/L: Mild hypercalcaemia.

→ Investigate: PTH (primary hyperparathyroidism), malignancy, sarcoidosis, medications. IV fluids if dehydrated. Check PTH, PTHrP, 25-OH vitamin D.

Moderate Hypercalcaemia 3.01–3.5

Corrected Ca²⁺ 3.0–3.5 mmol/L: Moderate hypercalcaemia. Symptomatic.

→ IV 0.9% saline 2–4 L/day. IV bisphosphonate (zoledronic acid 4 mg or pamidronate 60–90 mg). Consider calcitonin for rapid effect.

Severe Hypercalcaemia 3.51–99

Corrected Ca²⁺ > 3.5 mmol/L: Hypercalcaemic crisis. Life-threatening.

→ EMERGENCY. Aggressive IV saline. IV bisphosphonate URGENTLY. Haemodialysis if refractory. HDU. Treat underlying cause.

Interpretation bands for the Corrected Ca²⁺. Apply clinical judgement and local guidance.

References

Payne RB et al. Interpretation of serum total calcium. BMJ. 1973.

Curated clinical cross-links plus same-class fallbacks.

Calculators

Drugs

Pathways

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.

Score interpretation

References

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