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hypercalciuria

Excess Ca+2 in the urine. Etiology: 1) genetic a) absorptive hypercalcemia b) familial distal renal tubular acidosis c) Bartter syndrome d) familial hypocalciuric hypocalcemia 2) vitamin D excess 3) malignancy associated with a) bone resorption b) PTH-related protein secretion 4) primary hyperparathyroidism 5) vitamin D & calcium supplementation in postmenopausal women [3] 6) sarcoidosis [2] 7) idiopathic calciuria [4] Epidemiology: - most common metabolic abnormality in patients with Ca+2-containing urinary calculi Laboratory: - 24 hour urine calcium > 300 mg/day Complications: - urinary calculi, Ca+2-containing stones Management: - treat underlying etiology - an increase in dietary calcium paradoxically decreases risk of calcium oxalate stone formation & recurrence [2] - thiazide diuretics inhibit renal tubule excretion of Ca+2 - thiazide diuretic is recommended for nephrolithiasis associated with idiopathic hypercalciuria even in the absence of hypertension or edema [2]

Related

urinary calculus (stone, nephrolithiasis, urolithiasis)

Specific

absorptive hypercalciuria familial hypocalciuric hypercalcemia idiopathic hypercalciuria

General

sign/symptom

References

  1. Harrison's Principles of Internal Medicine, 13th ed. Isselbacher et al (eds), McGraw-Hill Inc. NY, 1994, pg 1330
  2. Medical Knowledge Self Assessment Program (MKSAP) 15, 16. American College of Physicians, Philadelphia 2009, 2012 - Medical Knowledge Self Assessment Program (MKSAP) 19 Board Basics. An Enhancement to MKSAP19. American College of Physicians, Philadelphia 2022
  3. Gallagher JC et al Incidence of hypercalciuria and hypercalcemia during vitamin D and calcium supplementation in older women. Menopause. June 16, 2014 PMID: 24937025 http://journals.lww.com/menopausejournal/Abstract/publishahead/Incidence_of_hypercalciuria_and_hypercalcemia.98368.aspx
  4. Coe FL, Worcester EM, Evan AP Idiopathic hypercalciuria and formation of calcium renal stones. Nat Rev Nephrol. 2016 Sep;12(9):519-33. PMID: 27452364 PMCID: PMC5837277 Free PMC article. Review.