24-Hour urine calcium

This podcast episode delivers a high-yield clinical review of 24-hour urine calcium interpretation for practicing endocrinologists managing complex calcium homeostasis disorders. The discussion details the physiology of renal calcium handling and establishes strict reference parameters to accurately identify hypercalciuria and hypocalciuria. Listeners will explore the contrasting urinary profiles of primary hyperparathyroidism and familial hypocalciuric hypercalcemia, emphasizing the diagnostic value and limitations of the calcium-creatinine clearance ratio. Finally, the episode addresses critical clinical confounders, including the cellular mechanisms of thiazide diuretics, the mathematical distortion of clearance ratios in chronic kidney disease, and the metabolic impact of idiopathic hypercalciuria and intestinal malabsorption.