Corrected Calcium Calculator

Table of Contents

What is corrected calcium and how is it calculated?

Corrected calcium reveals hidden imbalances by adjusting for low protein levels.

Using the Payne formula - Adds 0.8 mg/dL per 1 g/dL albumin drop.

Essential for chronic illness - Critical for liver, kidney, and malnourished patients.

Corrected calcium reveals hidden imbalances:

  • Think of albumin as calcium's personal taxi service. When you have fewer taxis (low albumin), the same amount of calcium circulates but less gets measured.
  • Corrected calcium adjusts for this protein shortage to show your true calcium status. 
  • A reading below 8.5 mg/dL (corrected) may need immediate treatment to prevent seizures or heart problems.

Payne formula:

  • The calculation is: Corrected Calcium = Measured Calcium + 0.8 × (4.0 - Your Albumin).
  • For every 1 g/dL your albumin drops below 4.0, we add 0.8 mg/dL to your calcium reading.

Crucial in chronic illness:

  • People with liver disease, kidney failure, or malnutrition often have low albumin.
  • Without correction, they can develop muscle spasms, weak bones, or heart problems despite "normal" lab results.
  • Guidelines require automatic correction when albumin drops below 3.5 g/dL.

How to use the corrected calcium calculator

How to use the calculator in 4 steps:

 

  1. Enter total (measured) calcium in mg/dL.
  2. Enter serum albumin in g/dL.
  3. Click "Calculate" to see results. 
  4. If you need to redo, click "Reset" to start fresh.

**All information is private, no data is saved or shared.**

Corrected Calcium Calculator

Corrected Calcium Calculator

Correct total serum calcium for albumin (Payne formula).

If albumin is unavailable, the calculator will show uncorrected Ca only.

FAQs

Q1. When should I use corrected calcium?

  • Corrected calcium becomes essential when your protein levels drop. Calcium runs wild despite normal blood counts. Most clinical protocols require correction for all inpatients with albumin <3.5 g/dL.
  • Chronic illness patients - Liver, kidney, or malnourished conditions.
  • When symptoms mismatch labs - ie. Tingling hands but "normal" calcium.

Q2. Why not just measure ionised calcium instead?

  • Ionised calcium measures only the unbound, immediately active molecules. The catch is it requires special handling, rapid testing, and costs significantly more.
  • Corrected calcium gives you 90% of the accuracy for routine cases without the hassle. Reserve ionised testing for critical situations where every decimal point matters.

Q3. What are the limitations of calcium correction?

  • The Payne formula assumes normal blood chemistry. In severe acidosis, calcium "jumps off" albumin proteins regardless of levels.
  • With unusual proteins (multiple myeloma), calcium binds unpredictably.
  • When albumin crashes below 2.0, the math becomes less reliable.
  • The rule: if corrected calcium doesn't match clinical symptoms (tingling, spasms, confusion), trust the patient, not the calculator.

References

1.Calvi, L.M. and Bushinsky, D.A. (2008). When Is It Appropriate to Order an Ionized Calcium? Journal of the American Society of Nephrology, 19(7), pp.1257–1260. doi:https://doi.org/10.1681/asn.2007121327. Link 

 

2. Goyal, A., Anastasopoulou, C., Ngu, M. and Singh, S. (2024). Hypocalcemia. [online] PubMed. Available at: https://www.ncbi.nlm.nih.gov/books/NBK430912 [Accessed 24 Nov. 2025]. Link

 

3. KDIGO 2017 Clinical Practice Guideline Update for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease–Mineral and Bone Disorder (CKD-MBD). (2017). Kidney International Supplements, 7(1), pp.1–59. doi:https://doi.org/10.1016/j.kisu.2017.04.001. Link

 

4. Payne, R.B., Little, A.J., Williams, R.B. and Milner, J.R. (1973). Interpretation of Serum Calcium in Patients with Abnormal Serum Proteins. BMJ, 4(5893), pp.643–646. doi:https://doi.org/10.1136/bmj.4.5893.643. Link

 

5. Slomp, J., van der Voort, P.H.J., Gerritsen, R.Th., Berk, J.A.M. and Bakker, A.J. (2003). Albumin-adjusted calcium is not suitable for diagnosis of hyper- and hypocalcemia in the critically ill. Critical Care Medicine, [online] 31(5), pp.1389–1393. doi:https://doi.org/10.1097/01.ccm.0000063044.55669.3c. Link