What are the differing approaches to the evaluation of hypercalciuria?

Updated: Jun 02, 2021
  • Author: Stephen W Leslie, MD, FACS; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Many different processes and disease states can produce overlapping symptoms and similar findings on urinalysis. A directed, stepwise approach is important in the evaluation of a patient with symptoms or a history compatible with hypercalciuria to avoid unnecessary expense, exposure to radiation, and patient discomfort. The first task is to document hypercalciuria. Looking for commonly associated urinary findings or problems that can produce similar symptoms is easy and inexpensive.

Two distinct approaches to the laboratory evaluation of hypercalciuric patients exist: the traditional approach and the simplified clinical approach. With both, initial blood tests, such as serum calcium, creatinine, and phosphate studies, should be performed to identify patients at risk for hyperparathyroidism, renal failure, and renal phosphate leak. Once hyperparathyroidism has been excluded, the 2 approaches differ. [4]

In the traditional approach, an effort is made to formally study the exact cause of the hypercalciuria, ultimately establishing a more precise diagnosis and leading directly to the most appropriate therapy based on etiology.

The simplified clinical approach uses a goal-oriented focus with therapeutic trials of therapy. A precise diagnosis may not be determined by this system.

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