Urinary Calcium Measurement in Patients With Hypercalcaemia; Endocrine Physicians and Surgeons Survey Results From UK

IF 2.4 3区医学 Q2 ENDOCRINOLOGY & METABOLISM

Clinical Endocrinology Pub Date : 2025-08-03 DOI:10.1111/cen.70008

Muhammad Fahad Arshad, Saba P. Balasubramanian

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引用次数: 0

Abstract

Background

In patients with hypercalcaemia, assessment of urinary calcium excretion helps differentiate primary hyperparathyroidism (PHPT) from familial hypocalciuric hypercalcaemia (FHH). For this, 24 h calcium to creatinine clearance ratio (CCCR) is recommended, but others tests like random CCCR, 24 h urine calcium excretion (UCE), and calcium to creatinine ratio (CR) are also frequently used.

Objective

The survey objective was to evaluate current practice among UK endocrinologists and surgeons.

Methods

A web-based anonymous cross-sectional survey, consisting of eight multiple-choice questions was developed using Survey Monkey. The survey was disseminated to members of British Association of Endocrine and Thyroid Surgeons (BAETS) and Society for Endocrinology (SfE) between November 20, 2025 and December 19, 2024.

Results

Two hundred and sixty-six responses from 210 endocrinologists and 56 surgeons were received (85% consultants). Respondents worked in both university (48.9%) and district hospitals (47.7%). The most commonly performed urine calcium test in hypercalcaemic patients was 24 h UCE (58.6%), but for PHPT versus FHH differentiation, the most preferred test was 24 h CCCR (43.6%), followed by random CCCR (24.8%), 24 h UCE (14.3%), and CR (16.5%). Of respondents who had experience with using CCCR (n = 235), most (55.6%) used a cut-off of > 0.01 to rule out FHH, while > 0.02 cut off was used by 26.7% respondents. Most clinicians (70.3%) used albumin-adjusted calcium for CCCR calculation, and 71.4% respondents considered vitamin D levels ≥ 50 nmol/L to be adequate for urinary calcium measurement.

Conclusion

The survey provides valuable insight into current UK practice. 24 h and random CCCR are the most commonly used tests to exclude FHH, but overall, practice varies widely.

Abstract Image

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高钙血症患者尿钙的测定英国内分泌内科医生和外科医生调查结果。

背景：在高钙血症患者中，评估尿钙排泄有助于区分原发性甲状旁腺功能亢进（PHPT）和家族性低钙性高钙血症（FHH）。为此，推荐使用24 h钙与肌酐清除率（CCCR），但也经常使用随机CCCR、24 h尿钙排泄量（UCE）和钙与肌酐比（CR）等其他测试。目的：调查目的是评估目前英国内分泌学家和外科医生的做法。方法：使用survey Monkey进行基于网络的匿名横断面调查，包括8个选择题。该调查于2025年11月20日至2024年12月19日期间分发给英国内分泌和甲状腺外科医生协会（BAETS）和内分泌学会（SfE）的成员。结果：共收到210名内分泌科医生和56名外科医生的266份反馈，其中咨询医生占85%。受访者同时在大学（48.9%）和地区医院（47.7%）工作。高钙血症患者最常进行的尿钙试验是24小时UCE(58.6%)，但对于PHPT和FHH分化，最受欢迎的试验是24小时CCCR(43.6%)，其次是随机CCCR(24.8%)， 24小时UCE（14.3%）和CR（16.5%）。在有使用CCCR经验的受访者中（n = 235），大多数（55.6%）使用> 0.01的截止值来排除FHH，而26.7%的受访者使用> 0.02的截止值。大多数临床医生（70.3%）使用白蛋白调整钙来计算CCCR， 71.4%的受访者认为维生素D水平≥50 nmol/L足以测量尿钙。结论：该调查为当前英国的实践提供了有价值的见解。24小时和随机CCCR是排除FHH最常用的测试，但总体而言，实践差异很大。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Endocrinology 医学-内分泌学与代谢

CiteScore

6.40

自引率

3.10%

发文量

192

审稿时长

1 months

期刊介绍： Clinical Endocrinology publishes papers and reviews which focus on the clinical aspects of endocrinology, including the clinical application of molecular endocrinology. It does not publish papers relating directly to diabetes care and clinical management. It features reviews, original papers, commentaries, correspondence and Clinical Questions. Clinical Endocrinology is essential reading not only for those engaged in endocrinological research but also for those involved primarily in clinical practice.