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24-hour urinary calcium in primary hyperparathyroidism.

Carrie E Black1, Richard L Berg, Andrew C Urquhart

  • 1Corresponding Author: Andrew Urquhart, MD; Otolaryngology - Head and Neck Surgery; Marshfield Clinic; 1000 North Oak Avenue; Marshfield, WI 54449; Phone: (715) 387-5245; Fax: (715) 389-5757;

Clinical Medicine & Research
|February 11, 2014
PubMed
Summary

In patients with primary hyperparathyroidism (PHPT), 24-hour urine calcium levels showed little correlation with serum calcium or parathyroid hormone (PTH). Urine calcium correlated with age and renal function, but not disease-specifically.

Keywords:
24-hour urine calciumHypercalciuriaPrimary hyperparathyroidism

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Area of Science:

  • Endocrinology
  • Nephrology
  • Metabolic Bone Disease

Background:

  • Primary hyperparathyroidism (PHPT) is a common endocrine disorder characterized by elevated serum calcium.
  • The relationship between urinary calcium excretion and serum calcium levels in PHPT patients requires clarification.
  • Understanding these correlations is crucial for managing PHPT and preventing complications like kidney stones.

Purpose of the Study:

  • To determine the correlation between 24-hour urinary calcium and serum calcium in patients with PHPT.
  • To investigate the association of urinary calcium with parathyroid hormone (PTH), vitamin D, age, gender, and renal function.
  • To evaluate factors influencing urinary calcium excretion in the context of PHPT.

Main Methods:

  • Retrospective review of 214 patients who underwent parathyroidectomy for PHPT between 2000 and 2008.
  • Collection of preoperative data including serum calcium (total and ionized), PTH, vitamin D, age, gender, and 24-hour urine calcium and creatinine.
  • Statistical analysis using descriptive statistics to evaluate correlations.

Main Results:

  • A significant correlation was not found between 24-hour urine calcium and preoperative serum calcium, PTH, or vitamin D levels.
  • Significant correlations were observed between 24-hour urine calcium and age, serum creatinine, and urine creatinine (P<0.0001).
  • Age and urine creatinine differed significantly between groups with urinary calcium levels above and below 400 mg/24 hours.

Conclusions:

  • In PHPT patients undergoing parathyroidectomy, preoperative 24-hour urine calcium shows minimal correlation with preoperative serum calcium, PTH, or vitamin D.
  • Urinary calcium levels are associated with renal function and age, but these findings are not specific to PHPT.
  • The study suggests that urinary calcium levels in PHPT may not be a reliable indicator of serum calcium or disease severity.