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Family Medicine (Expert Forum)
Hyperparathyroidism ? (cont), GFR/Creatinine, high 24-Hr urine Ca
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
Questions in the Family Medicine forum are answered by Dr. J.M. Keyes. Topics covered include general health issues, adolescence, babies, child health, eating disorders, fitness, immunizations and vaccines, infectious diseases, medical tests and procedures, and senior health.
Hyperparathyroidism ? (cont), GFR/Creatinine, high 24-Hr urine Ca
by Mike-87, Feb 11, 2006 12:00AM
... new to medhelp.org ... I went ahead and paid for posting follow-on questions ...
Dr. Kevin,
Thank you for your response and clarification with regards to a PTH level that is in the normal range but “inappropriately” high. I have familiarized myself with the following criteria regarding parathyroid surgery.
- Serum Ca 1.0 mg/dL > upper limit (mine 10.8)
- 24-Hr urine Ca > 400mg (mine 675.7) !!!
- 30% reduction in creatinine clearance (please help w/this per below) ???
- Bone mineral density T-score < -2.5 at any site (my DXA scan is normal)
- Age < 50 years (I’m 41)
My GFR:
- This has me very confused, please help!
- Mine seems a bit high but stable, agree?
- Should I be concerned?
Weight 188 lbs, Age 41, Height 5’8”, white male
Serum Creatinine’s (fasting):
8/01 – 1.2 mg/dL
1/05 – 1.2
6/05 – 1.2
11/05 – 1.3
12/05 – 1.4 & 1.2
From DaVita (http://www.davita.com/gfr_calculator/)
- No weight input ???
- 71 mL/min > Stage 2 ???
From Cockcroft-Gault Calc (http://www.nephron.com/cgi-bin/CGSI.cgi)
- With age & weight input
- 96.9 mL/min > reduced or no ???
Given the above condition of my kidneys, to what degree should I be concerned? What's with my 24-Hr urinary calcium being so high? I will ask my Endo about checking my vitamin D next week.
Thanks again,
Mike
Dr. Kevin,
Thank you for your response and clarification with regards to a PTH level that is in the normal range but “inappropriately” high. I have familiarized myself with the following criteria regarding parathyroid surgery.
- Serum Ca 1.0 mg/dL > upper limit (mine 10.8)
- 24-Hr urine Ca > 400mg (mine 675.7) !!!
- 30% reduction in creatinine clearance (please help w/this per below) ???
- Bone mineral density T-score < -2.5 at any site (my DXA scan is normal)
- Age < 50 years (I’m 41)
My GFR:
- This has me very confused, please help!
- Mine seems a bit high but stable, agree?
- Should I be concerned?
Weight 188 lbs, Age 41, Height 5’8”, white male
Serum Creatinine’s (fasting):
8/01 – 1.2 mg/dL
1/05 – 1.2
6/05 – 1.2
11/05 – 1.3
12/05 – 1.4 & 1.2
From DaVita (http://www.davita.com/gfr_calculator/)
- No weight input ???
- 71 mL/min > Stage 2 ???
From Cockcroft-Gault Calc (http://www.nephron.com/cgi-bin/CGSI.cgi)
- With age & weight input
- 96.9 mL/min > reduced or no ???
Given the above condition of my kidneys, to what degree should I be concerned? What's with my 24-Hr urinary calcium being so high? I will ask my Endo about checking my vitamin D next week.
Thanks again,
Mike
Doctor's Answer
by Kevin Pho, MD, Feb 12, 2006 12:00AM
, Feb 12, 2006 12:00AM
A GFR above 90 is considered normal. Combined with a normal, stable creatinine level, it is less likely that kidney damage is present.
The high urinary calcium can be a result of the high serum calcium you are experiencing. This is done via a calcium-sensing receptor leading to the increased urinary calcium excretion.
Options can be discussed with your personal endocrinologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
The high urinary calcium can be a result of the high serum calcium you are experiencing. This is done via a calcium-sensing receptor leading to the increased urinary calcium excretion.
Options can be discussed with your personal endocrinologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
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