How does alkalosis affect ionized calcium?

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Multiple Choice

How does alkalosis affect ionized calcium?

Explanation:
Alkalosis raises blood pH, which increases albumin’s affinity for calcium. Since most calcium is bound to albumin, tighter binding leaves less calcium in the free, ionized form. Ionized calcium is the physiologically active fraction, so alkalosis leads to a decrease in ionized calcium even if total calcium stays the same. (For contrast, acidosis tends to increase ionized calcium by reducing binding.)

Alkalosis raises blood pH, which increases albumin’s affinity for calcium. Since most calcium is bound to albumin, tighter binding leaves less calcium in the free, ionized form. Ionized calcium is the physiologically active fraction, so alkalosis leads to a decrease in ionized calcium even if total calcium stays the same. (For contrast, acidosis tends to increase ionized calcium by reducing binding.)

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