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Dear Dr Sodi I attach the proof of a Clin Chem letter in press about the Smith /et al/ paper. (It also has some relevance to the remarkable paper from Norway.) The actual suggestion of Smith /et al/ was to restrict adjusted calcium reporting */for/* albumins <30 g/L (by BCP) rather than /*to* /albumins <30//g/L. My main clinical concern is that treatable hypercalcaemia may never be considered as a possible cause of symptoms in hypoalbuminaemic patients who have a normal total calcium. With best wishes Brian Payne On 21/03/19 22:52, R Sodi wrote: > Dear colleagues, > > To add to the debate, two very recent articles in leading journals > have questioned the notion of ‘adjusted calcium’: > Lian & Asberg, BMJ Open 2018;8:e017703 > Smith et al, Clinical Chemistry 2018;64:1713-22 > (Sorry I can’t attach the papers but they are easily accessible). > > The first suggests this practice should be abandoned whereas the > second suggests restricting it to albumin <30 g/L. Are we as a > profession questioning entrenched practices? > > /Dr Rav Sodi PhD, FRCPath/ > /Consultant Biochemist / > > On 21 Mar 2019, at 15:20, DEANS, Kevin (NHS GRAMPIAN) > <[log in to unmask] > <mailto:[log in to unmask]>> wrote: > >> Hi Jonathan, >> >> Thanks for this – I’ve passed it on to Emma. >> >> Looking forward to continuing the discussion in Glasgow! >> >> Best wishes, >> >> Kevin >> >> *From:*Clinical biochemistry discussion list >> [mailto:[log in to unmask]] *On Behalf Of *Jonathan Kay >> *Sent:* 21 March 2019 15:12 >> *To:* [log in to unmask] >> <mailto:[log in to unmask]> >> *Subject:* Re: Focus 2019 - Scientific and Social Programmes >> >> Will that include the option of using the same measured values to >> produce an estimate of the ionised calcium concentration? >> >> That would be much safer now that clinicians are also getting ionised >> calcium results from PoCT assays and much easier to explain. >> >> You have nothing to lose but your (historical) chains. >> >> Jonathan >> >> PS: Can anyone send me Emma’s email address or forward this to her? >> Thanks. >> >> On 21 Mar 2019, at 14:40, Focus 2019 <[log in to unmask] >> <mailto:[log in to unmask]>> wrote: >> >> The question of how best to adjust serum calcium in relation to >> albumin will be addressed by Emma Ritchie, a Principal Clinical >> Scientist based at Aberdeen Royal Infirmary and an Honorary >> Lecturer at the University of Aberdeen. Currently, most >> laboratories use a single adjustment equation regardless of >> patient age or gender. Pathology Harmony has recommended using >> adjustment equations normalised to a mean calcium concentration >> of 2.4 mmol/L, with a reference interval of 2.2 to 2.6 mmol/L. >> The session will examine approaches to calcium adjustment, using >> big data to generate age- and gender- appropriate calcium >> adjustment equations. The presentation will discuss the >> implications of these data for Clinical Biochemistry laboratories. >> >> ------ACB discussion List Information-------- This is an open >> discussion list for the academic and clinical community working in >> clinical biochemistry. Please note, archived messages are public and >> can be viewed via the internet. Views expressed are those of the >> individual who posts and they are solely responsible for all message >> content. The ACB does not monitor posts. 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ACB Web Site >> http://www.acb.org.uk Green Laboratories Work >> http://www.laboratorymedicine.nhs.uk List Archives >> http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List >> Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ > ------ACB discussion List Information-------- This is an open > discussion list for the academic and clinical community working in > clinical biochemistry. Please note, archived messages are public and > can be viewed via the internet. Views expressed are those of the > individual who posts and they are solely responsible for all message > content. The ACB does not monitor posts. ACB Web Site > http://www.acb.org.uk Green Laboratories Work > http://www.laboratorymedicine.nhs.uk List Archives > http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List > Instructions (How to leave etc.) http://www.jiscmail.ac.uk/ --- This email has been checked for viruses by Avast antivirus software. https://www.avast.com/antivirus ------ACB discussion List Information-------- This is an open discussion list for the academic and clinical community working in clinical biochemistry. Please note, archived messages are public and can be viewed via the internet. Views expressed are those of the individual who posts and they are solely responsible for all message content. The ACB does not monitor posts. ACB Web Site http://www.acb.org.uk Green Laboratories Work http://www.laboratorymedicine.nhs.uk List Archives http://www.jiscmail.ac.uk/lists/ACB-CLIN-CHEM-GEN.html List Instructions (How to leave etc.) http://www.jiscmail.ac.uk/