Abstract
Hypercalciuria in children is diagnosed when the urinary calcium excretion is greater than 4.0 mg/kg in 24 hours, the ratio of urinary concentration of calcium to creatinine (UCa/UCr) is greater than 0.20, and there is normal serum calcium. Hypercalciuria may be the result of increased intestinal absorption of calcium (absorptive hypercalciuria) or an impaired proximal tubular defect in calcium reabsorption (renal hypercalciuria). Oral calcium load tests will differentiate the two types of hypercalciuria. Elevated fasting UCa/UCr with normal levels of parathormone (PTH) or urinary cyclic-AMP indicates renal hypercalciuria. After an oral calcium load, the UCa/UCr ratio will be greater than normal in absorptive hypercalciuria. However, Hymes and Warshaw suggest that both subtypes may coexist in some patients.
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