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Endocrine Abstracts (2024) 99 OC10.4 | DOI: 10.1530/endoabs.99.OC10.4

ECE2024 Oral Communications Oral Communications 10: Calcium and Bone | Part II (6 abstracts)

Morning urinary Calcium/Creatinine Ratio as screening tool for hypercalciuria in patients with hypoparathyroidism

Christina Berr 1 , Carmina Teresa Fuss 2 , Karen Gronemeyer 2 , Christian Pfob 3 , Thomas Pusl 1 & Stefanie Hahner 2


1Augsburg, Department of Endocrinology, I. Medical Clinic, University Hospital Augsburg, Augsburg, Germany; 2Würzburg, Endocrinology and Diabetes Unit, Department of Medicine I, University Hospital Würzburg, Würzburg, Germany; 3Augsburg, Nuclear Medicine, Faculty of Medicine, University of Augsburg, Augsburg, Germany


Background: Hypercalciuria is a relevant complication in patients with treated hypoparathyroidism. Hypercalciuria is usually estimated by 24 h urinary calcium excretion (24 hUCa). In contrast, in pediatric endocrinology the calcium-creatinine-ratio (CaCrR) is more often used due to feasibility. This study aims to compare these two approaches in adult patients with hypoparathyroidism.

Methods: In 181 systematically evaluated patients with primary hypoparathyroidism (93% postoperative, 73% female), the 24 hUCa was compared with the CaCrR of a fasting morning spot urine. All patients were evaluated at two University hospitals.

Results: 60% of patients met the sex-specific targets of 24 hUCa (<6.23 mmol/d for female, <7.51 mmol/d for men). CaCrR of spot urine correlated significantly with 24 hUCa (n=181, r=0.583, P<0.001). Although there were no significant differences between sexes in serum Calcium and 24 hUCa, females showed significant higher CaCrRs than men (0.41 vs 0.28; P=0.02) due to lower creatinine levels (P=0.001). In an ROC-analysis of the CaCrR the cutoff of 0.31 mmol/mmol correctly identified hypercalciuria in men with a sensitivity of 83.3% and a specificity of 86.7% (AUROC 0.88). By contrast, in females the optimal cutoff of 0.31 mmol/mmol only discriminated hypercalciuria from normocalciuria with a sensitivity of 83.3% and a specificity of 64.6% (AUROC 0.82). The negative predictive value for males was 86%. For females it was 64% (cutoff 0.3 mmol/mmol) or 85% (cutoff 0.45 mmol/mmol), respectively.

Conclusion: There are sex-specific differences in CaCrRs between female and male patients with hypoparathyroidism. Only in male patients a cutoff of 0.31 mmol/mmol discriminated well between normocalciuria and hypercalciuria. Highlight: To our knowledge, this is the largest cohort of patients with hypoparathyroidism in which urinary calcium excretion has been systematically investigated under standardized conditions.

Volume 99

26th European Congress of Endocrinology

Stockholm, Sweden
11 May 2024 - 14 May 2024

European Society of Endocrinology 

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