What are the most common types of hypercalciuria?

Updated: Apr 23, 2019
  • Author: Stephen W Leslie, MD, FACS; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

The following are the most common types of clinically significant hypercalciuria, although evidence suggests that this classic differentiation is insufficient to explain all of the cellular and genetic variations that have been noted in the condition [6] :

  • Absorptive hypercalciuria
  • Renal phosphate leak hypercalciuria (also known as absorptive hypercalciuria type III)
  • Renal leak hypercalciuria
  • Resorptive hypercalciuria

It is uncertain whether these different types of hypercalciuria are truly separate and distinct entities or are instead just the extremes of a single, unified process. Although the answer to this question is not currently known, the evidence and the consensus opinion lean toward the unified theory. In reality, other than for research purposes, this question has little impact clinically, because ultimately whatever therapy works is required. Table 2, below, provides simple test guidelines for specific diagnoses of hypercalciuria. (See Treatment and Medication.)

Table 2. Hypercalciuria Simplified Test Guideline (Open Table in a new window)

Hypercalciuria Diagnosis

Urinary Calcium on 400-mg Calcium Diet

(Normal = < 200 mg/24 h)

Fasting Calcium/Creatinine (mg/dL) Ratio

(Normal = < 0.11)

Post–Calcium Load Calcium/Creatinine Ratio

(Normal = < 0.20)

Normal

Normal

Normal

Normal

Absorptive type I

High

Normal

High

Absorptive type II

Normal

Normal

High

Absorptive type III (renal phosphate leak)

High

High

High

Renal leak

High

High

High

Resorptive (hyperparathyroidism)

High

High

High


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