For a patient with idiopathic hypercalciuria and a history of calcium kidney stones who has not normalized 24-hr urine calcium level on thiazide diuretic, is there evidence for targeting a certain urine calcium level for decreased future risk of nephrolithiasis and osteoporosis?

A good question, and the answer depends on your definition of a "normal" urine calcium level. If you use the standard definition of abnormal, the upper 5 percentile, depending on your laboratory, you will get values for upper normal calciuria in the 250-300 mg per day. However, approximately 10% of ...

Great comments, and I agree. I typically target <200 mg/24 hours and focus on a low sodium and low animal protein diet in addition to thiazide diuretics, and I typically use chlorthalidone at 25 or indapamide at 1.25 or 2.5mg depending on their baseline blood pressure. In my calcium phosphate stone ...