In asymptomatic patients with mild CKD, PTH independent hypercalcemia, and hypercalciuria—after excluding common causes such as hyperparathyroidism, vitamin D abnormalities, multiple myeloma, thyroid disease, vitamin A excess, and antacid use—what is the next best step in evaluation?

Answer from: at Academic Institution

It would be helpful to have more information. What is the serum calcium, urinary calcium creatinine ratio, 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D, urine NTX or serum CTX, phosphorus, P1NP or osteocalcin, creatinine clearance?

Comments

at Endocrinology Associates Pa
Thanks for your reply: Serum calcium 10.8, ioni...

at Boston University School of Medicine
You have now ruled out granulomatous disorders suc...

at Endocrinology Associates Pa
The PTHrp was normal. I will order the bone marke...

at Endocrinology Associates Pa
Dr. @Holick- The above patient had an elevated CTX...

at Boston University School of Medicine
The patient has high bone turnover. The factor nee...

at Endocrinology Associates Pa
Calcium 10.9 Albumin 4.3 PTH 20 Phosphorus 3....

at Boston University School of Medicine
Has the patient had any significant weight loss fo...

at Endocrinology Associates Pa
No weight loss and feels very well...

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In asymptomatic patients with mild CKD, PTH independent hypercalcemia, and hypercalciuria—after excluding common causes such as hyperparathyroidism, vitamin D abnormalities, multiple myeloma, thyroid disease, vitamin A excess, and antacid use—what is the next best step in evaluation?

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