Analysis index

10 ml of 24-hour urine, collected on 5 – 10 ml of glacial acetic acid.

After initial urination, the contents of the tube with glacial acetic acid (which is included in the delivery upon your request for a urine collection container), is transferred into the collection container. After that, all further urines are collected in the container. Prior to extracting the required sample amount, the collected urine has to be thoroughly mixed through. Total urine amount needs to be stated.

Men:                1,0 – 7,5 mmol/24 hrs

Women:           1,0 – 6,2 mmol/24 hrs 

Children:          Please refer to findings report

Additional test to calcium evaluation in the serum.

Hypercalciuria and hypercalcemia:

Primary hyperparathyroidism (60 % of patients show normal calcium urine levels however), vitamin D overdosing, granulomatous diseases such as sarcoidosis, tuberculosis, Crohn’s

Hypercalciuria without hypercalcemia:

Chronic hypokalemia, therapy with loop diuretics, renal tubulopathy such as type I renal tubular acidosis

Hypocalciuria and hypercalcemia:

Familial hypercalcemic hypocalciuria, primary hyperparathyroidism with concomitant vitamin D deficiency, thiazide diuretics

Hypocalciuria without hypercalcemia:

Vitamin D deficiency, chronic renal insufficiency, familial hypercalcemic hypocalciuria (FHH)

Familial hypercalcemic hypocalciuria (FHH) as well as a vitamin D deficiency with the suspicion of asymptomatic primary hyperparathyroidism must be ruled out. As the familial hypercalcemic hypocalciuria (FHH) can cause hypocalciuria or may show a normal calcium urine level in some cases – such as primary hyperparathyroidism – the fractionated calcium excretion (quotient from calcium and creatinine clearance) should be determined from spontaneous urine, for differentiation if a familial hypercalcemic hypocalciuria s suspected.

Fractionated calcium excretion =

Calcium concentration in urine x creatinine concentration in serum

Calcium concentration in serum x creatinine concentration in urine

A decreased quotient (< 0,01) indicates familial hypercalcemic hypocalciuria. Values > 0,02 indicate primary hyperparathyroidism. In between there is a grey area. Human genetic testing for familial hypercalcemic hypocalciuria can support the result.