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We studied, in 70 acidotic and non-acidotic uremic patients, the analytical variance in serum ionized calcium as related to duration and temperature of storage. Storage of serum or whole blood at 4 degrees C for as long as 6 h did not significantly alter the measured concentration of ionized calcium in the serum. Storage at room temperature for 6 h, or longer at 4 degrees C or -20 degrees C, resulted in inaccuracies in 39 to 79% of the samples of serum and in 38 to 92% of the samples of whole blood. These errors were not negated by correcting the values for ionized calcium to a pH of 7.40. Indeed, corrected values for calcium were even more unreliable in acidotic patients. We conclude that samples from uremic patients should be analyzed for ionized calcium within 2 h, or within 6 h if stored at 4 degrees C.
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