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Patients suffering from low bone density, hypercalciuria, and stone formation should increase daily fluid consumption and focus on a low sodium and low protein diet. Reducing calcium intake to attempt to remedy elevated urine calcium has been shown to further progress bone loss without an effect on
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The use of thiazide diuretics has been effective in reducing urine calcium loss and has an activating effect on bone forming cells. Potassium citrate in conjunction with thiazide diuretics is another medication that has been shown to have a positive impact on bone formation but also decrease the
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Idiopathic hypercalciuria is defined as elevated calcium in the urine without an identifiable cause despite low to normal calcium intake and otherwise normal lab values. In addition to hypercalciuria, these individuals often have associated low bone density. There can be an underlying genetic
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The gold standard to assess for hypercalciuria is 24-hour urine collection to evaluate urine calcium levels over that time period. Normal range is considered 100 to 300 milligrams per day (mg/day) with standard calcium intake. Hypercalciuria is diagnosed when a value over 300 mg/day is
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than normal, for which there are many possible causes. Calcium may come from one of two paths: through the gut where higher than normal levels of calcium are absorbed by the body or mobilized from stores in the bones. After initial 24 hour urine calcium testing and additional lab testing, a
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component that is beyond current genetic testing available. In familial cases it is common that 50% of first degree relatives are affected. Despite a potential genetic component, urine calcium levels can be influenced by dietary items including sodium, protein, and sugars.
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There are no clinical signs or symptoms of hypercalciuria itself but elevated calcium in the urine can contribute to accelerated loss of calcium from bone leading to
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formation which may present with flank or back pain that comes and goes. It can be painful to pass kidney stones and in extreme cases cause
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Other drugs are used to treat osteoporosis, including bisphosphonates, but have not been shown to have an effect on urine calcium levels.
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Additional laboratory testing is warranted in the setting of hypercalciuria in order to identify a potential underlying cause.
95:. Patients that both form kidney stones and have hypercalciuria are at increased risk for bone loss leading to osteoporosis.
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scan (DSX) may be performed to determine if the calcium is being obtained from the bones.
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There are a number of causes of hypercalciuria including genetic (idiopathic),
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63:. Patients with hypercalciuria have kidneys that excrete higher levels of
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328:"Idiopathic hypercalciuria: Can we prevent stones and protect bones?"
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Hypercalciuria in patients can be due to underlying genetic causes.
55:. Chronic hypercalciuria may lead to impairment of renal function,
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292:"Idiopathic hypercalciuria: MedlinePlus Medical Encyclopedia"
115:, Calcium excess, Vitamin D excess/increased sensitivity,
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Alexander, R. T.; Fuster, D. G.; Dimke, H. (2022-02-10).
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crystallization of calcium based stones in the kidneys.
243:"Hot Topic - Kidney Stones - Mayo Medical Laboratories"
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Abnormal clinical and laboratory findings for urine
87:. Additionally, hypercalciuria can contribute to
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377:"Mechanisms Underlying Calcium Nephrolithiasis"
326:Ryan, Laura E.; Ing, Steven W. (2018-01-01).
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393:10.1146/annurev-physiol-052521-121822
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268:"What is a Calcium Urine Test?"
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166:Pharmacological interventions
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51:is the condition of elevated
245:. 2014-03-14. Archived from
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381:Annual Review of Physiology
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117:drug-induced hypercalciuria
105:primary hyperparathyroidism
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155:Treatment and management
345:10.3949/ccjm.85a.16090
159:Dietary interventions
133:renal tubular acidosis
61:chronic kidney disease
143:Testing and diagnosis
163:urine calcium loss.
53:calcium in the urine
209:Hyperparathyroidism
522:External resources
214:Vitamin D toxicity
107:, immobilization,
79:Signs and symptoms
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423:"Calcium - Urine"
129:Cushing's disease
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22:Hypercalcinuria
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89:kidney stone
85:osteoporosis
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70:bone density
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387:: 559–583.
121:sarcoidosis
27:Other names
555:Categories
507:DiseasesDB
432:2023-02-28
301:2023-02-28
277:2023-02-28
253:2023-02-28
220:References
531:eMedicine
401:1545-1585
354:0891-1150
36:Specialty
539:ped/1063
536:med/1069
409:34699268
362:29328898
177:See also
566:Calcium
501:D053565
65:calcium
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131:, and
99:Causes
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272:WebMD
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