What are the primary mechanisms of elevated urinary calcium in hypercalciuria?

Updated: Jun 02, 2021
  • Author: Stephen W Leslie, MD, FACS; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Elevated urinary calcium occurs by 1 of 3 primary mechanisms, as follows:

  • The filtered load of calcium is abnormally increased without an adequate compensatory increase in tubular calcium reabsorption

  • The filtered calcium load is normal but tubular calcium reabsorption is reduced

  • The filtered load is increased and the reabsorbed load is reduced

A good screening test for hypercalciuria compares the ratio of urinary calcium to creatinine. To validate the screening test, an accurately timed urinalysis should be used to confirm any positive screens. (See Workup.)

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