Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020438 (hypercalciuria)
 2,502 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After detailed instruction, 62 patients with urolithiasis treated at Taichung Veterans General Hospital entered this program, which ran from September 1987 to November 1988. Based on Pak's classification, there were 13 cases (21.0%) of absorptive hypercalciuria, type I (AH-I); 12 cases (19.4%) of absorptive hypercalciuria, type II (AH-II); 16 cases (25.8%) of renal hypercalciuria (RH); 3 cases (4.8%) of hyperuricosuric calcium urolithiasis (HUCU); 11 cases (17.7%) of hypocitraturia (Hypocit); 3 cases (4.8%) of hyperoxluria (HO); one case (1.6%) of primary hyperparathyroidism (PHPT) and one case (1.6%) of infectious lithiasis. Two cases (3.2%) with no metabolic abnormalities were found. Hypocitraturia, HUCU, and HO can be the primary abnormal findings, but more often coexist with various forms of hypercalciuria as a second factor. If the coexistence is considered, hypocitraturia (33 cases, 53.2%) and HUCU (24 cases, 38.7%) were the most prevalent categories. Meanwhile, 24 cases (38.7%) had only one physiological derangement, 25 cases (40.3%) had two derangements, and 13 cases (21.0%) had three. This study indicates that metabolic evaluation can elucidate the physiological derangements of urolithiasis, so that further medical treatment can be administered selectively.
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PMID:Metabolic evaluation of urolithiasis. 197

Moderate dietary Na restriction (80 mmol/d for 7 days) during constant Ca intake can reduce high urinary Ca excretion to normal levels in idiopathic hypercalciuria (IH). A similar protocol was used to test its effect in primary hyperparathyroidism (PHPT) and also in hypoparathyroid subjects (HOPT) during treatment with dihydrotachysterol (DHT). Nine subjects with PHPT, 10 with HOPT, and one with pseudo-HOPT were evaluated after Na-restricted (80 mmol/d) and Na-supplemented (200 mmol/d) diets for 7 days each with dietary Ca constant. Na restriction resulted in a decrease in mean urinary 24-hour Ca excretion in PHPT subjects (10.6 v 7.6 mmol/d [424 v 304 mg], P less than 0.0001) and in one pseudo-HOPT subject, similar to the pattern seen previously in IH subjects. In contrast, Na restriction was not accompanied by significant change in Ca excretion in HOPT. There was no change in serum immunoreactive PTH (iPTH) or 1,25(OH)2 vitamin D levels in either group when Na intake was altered. Thus, the presence of parathyroid hormone (PTH) is necessary for sodium-related alterations in urinary Ca to occur. The effect of PTH appears to be "permissive" rather than "active." Dietary Na restriction may have a role in the management of hypercalciuria in mild PHPT cases when parathyroidectomy is contraindicated.
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PMID:Hypercalciuria in parathyroid disorders: effect of dietary sodium control. 199 77

On the basis of 3 infants with primary congenital hyperparathyroidism we discuss problems in the early diagnosis and interpretation of the results of laboratory findings. The lack of increased renal echogenicity and hypercalciuria, which is regularly present in idiopathic hypercalcaemia is emphasized. In contrast to secondary hyperparathyroidism caused by prolonged hypocalcaemia, e.g. in patients treated by longterm haemodialysis, the aetiology of primary hyperparathyroidism (pHPT) remained unclear although molecular genetic studies suggest that the development of parathyroid adenoma may be due to gene mutation in a cell. Congenital pHPT is a particularly rare condition usually due to diffuse hyperplasia of all parathyroid glands. Its inheritance is known to be autosomal. Three infants with congenital primary hyperparathyroidism were treated at the Child Health Centre in the years 1987-1988.
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PMID:Primary hyperparathyroidism in infants. Diagnostic and therapeutic difficulties. 203 3

The classical manifestations of primary hyperparathyroidism (hypercalcemia, hypophosphatemia, hypercalciuria, increased blood alkaline phosphatase level, and bone changes of the type of generalized osteoporosis) were found in approximately half of patients in a group of 23 who were examined. When Recklinghausen's disease is suspected, the patients must be subjected to a purposeful examination. The intraoperative diagnosis of parathyroid adenoma is difficult. In distinction from thyroid tissue, a lymph node, and adipose tissue a parathyroid adenoma almost always has a vascular pedicle, which makes verification of the diagnosis easier.
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PMID:[Diagnosis and treatment of parathyroid adenomas]. 206 59

We performed 6-h human PTH-(1-34) infusions in 8 control subjects, 10 subjects with primary hyperparathyroidism, and 7 men with idiopathic hypercalciuria. We measured serum calcium, serum 1,25-dihydroxyvitamin D, urinary calcium, and fractional phosphate excretion. The PTH-induced rise in serum 1,25-dihydroxyvitamin-D was significantly smaller in the hyperparathyroid patients than in either the controls or the hypercalciuric patients. The rise in serum calcium was similar in all 3 groups. The hyperparathyroid subjects had higher basal fractional phosphate excretion than the other two groups. PTH failed to increase fractional phosphate excretion in the hyperparathyroid individuals, whereas there was a statistically significant increase in the other two groups. PTH was without significant effect on urinary calcium excretion in any of the three groups. There were no discernible differences between the responses of the hypercalciuric patients and those of the normal subjects. These findings suggest that while responses to PTH are normal in hypercalciuria, some hyperparathyroid patients are resistant to exogenous PTH. This resistance is limited to specific arms of the PTH response pathway and may not involve PTH receptors.
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PMID:Parathyroid hormone sensitivity in primary hyperparathyroidism and idiopathic hypercalciuria: effects on postadenylate cyclase parameters. 215 86

We report results for adjusted ionized calcium (at pH 7.4) and actual ionized calcium (at actual pH) in capillary blood from 183 patients with disorders of calcium metabolism (primary hyperparathyroidism, secondary hyperparathyroidism of malabsorption, primary hypoparathyroidism, Paget's disease, acromegaly, hypercalcemia of malignancy, osteoporosis, sarcoidosis, idiopathic hypercalciuria, and familial hypocalciuric hypercalcemia). The correlation and the equation for the linear regression between adjusted ionized calcium (y) and actual ionized calcium (x) were y = 1.011x + 0.005 mmol/L, r = 0.992, Sy,x = 0.021 mmol/L. Results were similar within each diagnostic group. Consistent agreement between adjusted and ionized calcium was observed in 96.7% of patients representing a variety of the most frequently encountered disorders of calcium metabolism. Thus we find adjusted ionized calcium to be as useful as actual ionized calcium for evaluation of patients with such disorders. Adjusted ionized calcium may therefore also be a logical choice for establishing agreement between laboratories for reference intervals in healthy adults.
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PMID:Adjusted ionized calcium (at pH 7.4) and actual ionized calcium (at actual pH) in capillary blood compared for clinical evaluation of patients with disorders of calcium metabolism. 231 Dec 30

We retrospectively reviewed 32 patients who underwent parathyroidectomy at our hospital for the last fourteen years. 1) Clinical appearance of primary hyperparathyroidism was in younger age in women. 2) In previous history or at the time of PTX, 9 patients had malignant tumors including 6 thyroid cancers, 36% of the patients with out bone related symptoms had a remarkable decrease in bone mineral content. 3) After PTX, none of patients had recurrent urolithiasis and bone mineral content of all patients was significantly increased in a short time. In addition, upper GI complaints were improved, or hypertension was partially normalized. However, renal insufficiency remained unchanged. 4) In preoperative localization study, Ultrasound sonography (US) demonstrated the best accuracy rate of 88% when only one gland was involved. US was able to detect multiple gland involvement only in 20% of 5 cases. 5) Hypercalciuria was recognized as one of the risk factors of stone formation in patients with primary hyperparathyroidism.
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PMID:[Clinical study on 32 patients who underwent parathyroidectomy at Osaka City University Hospital]. 232 20

The bone mineral content of the radius was measured in 32 male renal stone formers, 18 of them presenting with idiopathic urolithiasis and 14 with primary hyperparathyroidism, a disease known to disturb bone metabolism. The idiopathic stone formers had been on regular treatment with a low calcium diet. The bone mineral content of the radius was reduced to a similar level in both groups of patients. The data suggest that idiopathic stone formers on a low calcium diet are at risk of osteopenia; the factors which could lead to a negative calcium balance included uncompensated renal hypercalciuria, hypophosphataemia and exaggerated serum levels of 1,25-dihydroxyvitamin D. To treat idiopathic hypercalciuria, thiazide diuretics, which reduce the renal excretion of calcium and have been shown to be beneficial for bone, seem safer than a low calcium diet.
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PMID:Low calcium diet in idiopathic urolithiasis: a risk factor for osteopenia as great as in primary hyperparathyroidism. 237 68

Experience in the diagnosis and treatment of the renal form of primary hyperparathyroidism in 57 patients with bilateral nephrolithiasis was summed up. The main diagnostic criterion was the detection of biochemical changes in the blood and urine (hypercalcemia, hypophosphatemia, hypercalciuria) and the use of some tests (Howard's test and parathyroidin test). Parathyroidectomy was performed after establishing diagnosis. A new stage in therapy of such patients was a study of renal function and phosphocalcium metabolism after parathyroidectomy. The improvement of some indices (an increase in glomerular filtration, urea excretion with urine and relative urine density, and a decrease in hypercalciuria and hyperphosphaturia) indicated the effectiveness of surgical intervention for primary hyperparathyroidism in patients with bilateral nephrolithiasis. It was also confirmed by a decrease in lithogenic relapse after parathyroidectomy.
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PMID:[Primary hyperparathyroidism in patients with bilateral nephrolithiasis]. 258 27

The authors analyze clinical and laboratorial features of 13 patients with surgically confirmed primary hyperparathyroidism (HPT). Among them, 8 presented renal lithiasis, 7 had bone disease, and 2 had both. All patients were hypercalcemic and had elevated serum carboxyterminal levels of PTH. The aminoterminal portion of the PTH was above the normal range in 9 patients and inappropriately high for the level of serum calcium in other two. The c'AMP was elevated in 7/8 patients. Hypophosphatemia was detected in 8/11 patients. Among the lithiasic patients, hypercalciuria was found in only 3. Five patients were submitted to an oral calcium load test which detected no intestinal hyperabsorption of calcium (IH) secondary to HPT in any of them. The rate of elimination of stones/patient/year was 1.7 before the establishment of HPT diagnosis. Despite the presence of renal lithiasis, hypercalciuria and IH were not common findings in HPT patients. Serum calcium and urinary c'AMP were the best screening tests for the diagnosis of HPT in this series. The diagnosis should be further confirmed determining the PTH.
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PMID:[Primary hyperparathyroidism: clinical and laboratory spectrum]. 264 May 6


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