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Low urine calcium excretion in African American patients with primary hyperparathyroidism.
[familial hypocalciuric hypercalcemia]
To
evaluate
the
prevalence
of
low
urine
calcium
excretion
in
African
American
patients
with
primary
hyperparathyroidism
(
PHPT
)
,
a
common
disorder
associated
with
bone
and
renal
complications
,
and
to
assess
the
distinction
between
PHPT
and
familial
hypocalciuric
hypercalcemia
(
FHH
)
,
a
rare
benign
genetic
disease
.
We
conducted
a
retrospective
study
on
a
cohort
of
1
,
297
patients
in
whom
a
24
-
hour
urine
study
was
performed
for
measurement
of
urine
calcium
and
creatinine
.
PHPT
was
diagnosed
if
the
serum
calcium
concentration
was
≥
10
.
5
mg
/
dL
and
intact
parathyroid
hormone
(
PTH
)
was
≥
40
pg
/
mL
.
Patients
receiving
medications
that
affect
urine
calcium
or
with
glomerular
filtration
rate
≤
30
mL
/
min
were
excluded
.
Ninety
-
six
patients
satisfied
the
diagnostic
criteria
for
PHPT
.
The
African
American
(
n
=
70
)
and
non-
African
American
(
n
=
26
)
patients
did
not
differ
in
their
mean
age
,
body
mass
index
,
glomerular
filtration
rate
,
serum
PTH
,
25
-
hydroxyvitamin
D
levels
,
and
24
-
hour
urine
creatinine
values
.
Median
values
of
urine
calcium
/
creatinine
(
mg
/
g
)
were
122
for
African
American
versus
214
for
non-
African
American
patients
(
P
=
.
006
)
.
Thirty
-
one
of
70
African
American
patients
(
44
%
)
had
a
urine
calcium
/
creatinine
ratio
≤
100
mg
/
g
,
whereas
only
2
of
26
non-
African
American
patients
(
8
%
)
had
this
value
(
P
=
.
001
)
.
The
prevalence
of
low
urine
calcium
excretion
among
African
American
patients
with
PHPT
is
unexpectedly
high
.
A
threshold
of
100
mg
/
g
urine
calcium
/
creatinine
identified
44
%
of
such
patients
with
PHPT
as
having
FHH
in
this
cohort
.
Therefore
,
other
clinical
criteria
and
laboratory
variables
should
be
used
to
distinguish
PHPT
from
FHH
in
African
American
patients
with
PTH
-dependent
hypercalcemia
.
Diseases
Validation
Diseases presenting
"other clinical criteria"
symptom
familial hypocalciuric hypercalcemia
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