Hi Larisa,

In the setting of hypercalcaemia and an inappropriately normal or raised PTH, a calcium to creatinine clearance ratio of > 0.02 is generally in keeping with primary hyperparathyroidism, and this cut-off has been recommended in the 2002 consensus guidelines for asymptomatic primary hyperparathyroidism. This definition stems from the studies published in the late 70s/early 80s, that compared the biochemical features of FHH and PHPT cohorts. Much of this work was carried out by Steven J. Marx, and some references that might be of interest to you are as follows: Marx SJ et al. Medicine 1981, Marx SJ et al. Am J Med 1978, Law WM and Heath H Ann Intern Med 1985.

Best wishes,

Fadil

Dr. Fadil Hannan
Clinical Lecturer
Dept. of Clinical Biochemistry
John Radcliffe Hospital
Oxford
Tel: 01865 220466


________________________________________
From: Clinical biochemistry discussion list [[log in to unmask]] On Behalf Of Wiedemann Larisa (RF4) BHR Hospitals [[log in to unmask]]
Sent: 09 February 2012 15:21
To: [log in to unmask]
Subject: Urine calcium to creatinine clearance - reference ranges

Hi all,

When measuring calcium to creatinine clearance ratio (fractional calcium excretion index) in 24 hour urine, we have used the following reference range:

<0.010 indicated FHH (familial hypocalciuric hypercalcaemia)
>0.03 indicated PHP (primary hyperparathyroidism)

Whilst I'm able to find multiple references to the "<0.01 indicates FHH" range, I'm struggling to locate the original source of the >0.03 cut off for PHP.

Could anyone help with establishing when/how this was determined?
Does anyone use anything different?


I'll be happy to collate responses and forward to those interested.

Many thanks in advance,

Larisa






Larisa Wiedemann

Pre-reg Clinical Scientist
Biochemistry Department
Queen's Hospital, Romford
Essex, RM7 0AG
Tel: 01708 435 506
Fax: 01708 503 735
DECT: 6194



Barking, Havering & Redbridge University Hospitals NHS Trust: Most Innovative Trust in London 2009


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