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1. Calcium is absorbed from the duodenum, stored in the bone, and excreted by the kidneys.

2. Regulated by PTH and vitamin D metabolites, which affect rates of absorption in the kidneys and gut and rates of resorption of bone.

3. The measured plasma calcium concentration is a total of free/ionized calcium (45%), calcium bound to albu­min (40%), and calcium bound to other substances (15%).

4. Ionized calcium is the state available for imme­diate use by the body and correlates with consequences of hyper- or hypocalcemia.

5. If albumin decreases, the measured plasma calcium decreases.


1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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