Maximal urine-concentrating ability

Familial hypocalciuric hypercalcemia versus typical primary hyperparathyroidism

S. J. Marx, M. F. Attie, J. L. Stock, A. M. Spiegel, M. A. Levine

Research output: Contribution to journalArticle

Abstract

Impairment of urine-concentrating ability is common in persons with chronic hypercalcemia. We assessed urine-concentrating ability in 40 patients with typical primary hyperparathyroidism and 10 patients with familial hypocalciuric hypercalcemia, a disorder resembling typical primary hyperparathyroidism but lacking some of its clinical complications. Urine-concentrating ability was determined during a dehydration test of 18-22 h. The two patient groups were comparable with respect to serum calcium concentration and creatinine clearance. In the group with familial hypocalciuric hypercalcemia, the duration of hypercalcemia was probably greater, because it commences during infancy; the urinary excretion rate for calcium was lower [6.6 ± 5.4 (mean ± 1 SD) vs. 14.8 ± 7.5 meq/day; P <0.005]. Patients with familial hypocalciuric hypercalcemia showed higher maximal urinary osmolality (860 ± 150 vs. 664 ± 130 mosmol/kg; P <0.0005). Among the patients with typical primary hyperparathyroidism, there was a negative association between maximal urinary osmolality and urinary cAMP (r = -0.40; P <0.05), but there was no significant relation between maximal urinary osmolality and the urinary excretion rate for calcium. Among 18 patients retested within 1 month after surgical correction of typical primary hyperparathyroidism, urine-concentrating ability did not improve. In patients with typical primary hyperparathyroidism, impairment in urine-concentrating ability reflects features of the chronic disease state, as it is not rapidly reversible by correction of that state. However, in patients with familial hypocalciuric hypercalcemia, longstanding hypercalcemia is not associated with obvious impairment of urine-concentrating ability. Complete or partial freedom from impairment of urine-concentrating ability and from calcareous renal disease are expressions of the generally mild course in familial hypocalciuric hypercalcemia.

Original languageEnglish (US)
Pages (from-to)736-740
Number of pages5
JournalJournal of Clinical Endocrinology and Metabolism
Volume52
Issue number4
StatePublished - 1981
Externally publishedYes

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Kidney Concentrating Ability
Primary Hyperparathyroidism
Calcium
Hypercalcemia
Osmolar Concentration
Dehydration
Creatinine
Association reactions
Hypocalciuric hypercalcemia, familial, type 1
Chronic Disease

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Maximal urine-concentrating ability : Familial hypocalciuric hypercalcemia versus typical primary hyperparathyroidism. / Marx, S. J.; Attie, M. F.; Stock, J. L.; Spiegel, A. M.; Levine, M. A.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 52, No. 4, 1981, p. 736-740.

Research output: Contribution to journalArticle

Marx, S. J. ; Attie, M. F. ; Stock, J. L. ; Spiegel, A. M. ; Levine, M. A. / Maximal urine-concentrating ability : Familial hypocalciuric hypercalcemia versus typical primary hyperparathyroidism. In: Journal of Clinical Endocrinology and Metabolism. 1981 ; Vol. 52, No. 4. pp. 736-740.
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