Laboratory for Molecular Diagnostics
Center for Nephrology and Metabolic Disorders

Hypercalciuria

Hypercalciuria is increased renal calcium excretion despite of normal or low serum calcium.

Demarcation

Malignancies may cause hypercalciuria by three different mechanisms (1) excretion of hormone active substances such as PTH-related protein, (2) bone metastases, (3) mulitple myeloma.

Pimary hyperparathyroidism.

Hyperthyroidism.

Glucocorticoid therapy and Cushing syndrome.

Estrogen deficiency, for instance after ovarectomy.

Immobilization and long stay in a state of weightlessness.

Sarcoidosis (Boeck) increases the production of Calcitriol.

Milk-alkali syndrome or other types of excessive calcium intake.

Diagnosis

Normal daily calcium excretion in women and men is 6.2 mmol (250mg) and 7,5mmol (300mg) respectively. That is 0.1 mmol (4 mg) per kg body mass. In infants the upper limit is 3.62mmol Calcium per mmol Creatinin (0.8g/g).

Diseases

Distal renal tubular acidosis (autosomal dominant)
Hypercalciuria in autosomal dominant distal renal tubular acidosis is an occasional not a typical finding.
Apparent mineralocorticoid excess
Hypercalciuria in AME patients is likely the cause of nephrocalcinosis.
Antenatal Bartter syndrome type 1
Hypercalciuria in antenatal Bartter syndrome causes nephrocalcinosis. Furthermore renal salt an water wastage dominate the clinical picture. Hypokalemia and metabolic alkalosis are the most prominent clinical symptoms.
Antenatal Bartter syndrome type 2
Hypercalciuria in antenatal Bartter syndrome causes nephrocalcinosis. Furthermore renal salt an water wastage dominate the clinical picture. Hypokalemia and metabolic alkalosis are the most prominent clinical symptoms.
Bartter syndrome
By contrast to antenatal, hypercalciuria in classic Bartter syndrome does not cause nephrocalcinosis. Furthermore renal salt an water wastage dominate the clinical picture. Hypokalemia and metabolic alkalosis are the most prominent clinical symptoms.
Dent disease
Hypercalciuria in Dent disease is a typical and early symptom but detected only if explicitly searched for. It accompanied by low molecular weight proteinuria and hypophosphatemia. As an x-linked recessive disorder boys are affected.
Fanconi renotubular syndrome 2
Along with other proximal tubular damage renal calcium wastage is observed.
Hypomagnesemia with hypercalciuria and nephrocalcinosis with ocular involvement
Hypercalciuria in FHHNC is accompanied by hypomagnesemia and nephrocalcinosis.
Hypomagnesemia with hypercalciuria and nephrocalcinosis
Hypercalciuria in FHHNC is accompanied by hypomagnesemia and nephrocalcinosis.
Hypophosphatemic rickets with hypercalciuria
Hypercalciuria is a cardinal symptom in HHRH and typically accompanied by bone deformations.
Nephrolithiasis/osteoporosis, hypophosphatemic, 1
Renal calcium wastage is responsible for osteoporosis and nephrocalcinosis.
Infantile hypercalcemia
Hypercalciuria is most likely due to elevated plasma calcium levels.
Update: Sept. 26, 2018

 

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