How is hypercalciuria treated?

Updated: Jun 02, 2021
  • Author: Stephen W Leslie, MD, FACS; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Although optimal levels of urinary calcium have not been determined, less than 125 mg of calcium per liter of urine has been suggested as a reasonable optimal goal for most calcium-stone formers.

Dietary modifications have long been the mainstay of initial therapy for hypercalciuria. All hypercalciuric patients are advised to follow reasonable dietary changes to help limit their urinary calcium loss, reduce stone recurrences, and improve the effectiveness of medical therapy. Although dietary changes alone may not always be a successful or adequate treatment, dietary excesses possibly can undermine or defeat even optimal medical therapies.

On the other hand, patients who normalize their urinary calcium excretion with dietary changes alone may still benefit from thiazides or other therapies to avoid or treat bone demineralization and osteoporosis or osteopenia. [35]

Reducing intestinal calcium inadvertently may increase oxalate absorption and contribute to hyperoxaluria, resulting in a net increase in stone formation risk rather than a reduction. This is why dietary oxalate is limited whenever calcium intake is reduced.

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