Commentary & Perspectives

Adjusted Calcium Is Lying — And Labs Keep Printing It

Choy et al. argue it's time to stop trusting a number that's been unreliable for fifty years.

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In a critical evaluation, Chiang and Choy assert that the long-standing practice of using albumin-adjusted calcium as a universal screening tool should be reconsidered. They highlight that the formula may misrepresent true calcium levels, particularly in older patients and those with renal issues, where physiological disturbances alter calcium's bioavailability. Despite evidence dating back to 1975 questioning the formula's validity, the persistence of auto-reporting this adjusted value reflects inertia rather than scientific rationale. The authors advocate for ionised calcium to be adopted as a more reliable measure, especially in acute healthcare settings.

Original Source(s)

Adjusted Calcium Is Lying — And Labs Keep Printing It

  • by Kerri Miller

  • March 18, 2026

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