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Evidence for the Hormonal Basis of Familial Hypercalciuria

Leonard C. Hymes, MD; Barry L. Warshaw, MD

Am J Dis Child. 1985;139(6):621-624.

Abstract
• Six children with idiopathic hypercalciuria and their families were examined with an oral calcium loading test. Family members were divided into two clinical categories: group 1 consisted of the six index children and their parents and siblings with urolithiasis or unexplained hematuria; group 2 comprised the remaining parents and siblings without signs or symptoms associated with hypercalciuria. The results revealed that fasting urinary excretion of calcium was similar in both groups, but group 1 displayed a greater calciuric response to an oral calcium load. Serum concentrations of calcitriol (1,25-dihydroxyvitamin D³) and calcium were higher in group 1 than in group 2, while parathyroid activity was lower in group 1 patients. Urinary excretion of sodium, phosphorus, and magnesium, urine pH, serum levels of calcifediol (25-hydroxyvitamin D³) and phosphorus, and the renal tubular threshold for phosphate were not significantly different in the two groups. These findings suggest that idiopathic hypercalciuria may arise from a disturbance in the regulation of vitamin D metabolism that mediates enhanced intestinal absorption of calcium.

(AJDC 1985;139:621-624)

Author Affiliations
From the Department of Pediatrics, Division of Nephrology, Emory University School of Medicine, Atlanta.

Footnotes
Reprint requests to Department of Pediatrics, Emory University School of Medicine, 2040 Ridgewood Dr NE, Atlanta, GA 30322 (Dr Hymes).

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