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The gold standard to assess for hypercalciuria is 24-hour urine collection to evaluate urine calcium levels over that time period. Normal range is considered 100 to 300 milligrams per day (mg/day) with standard calcium intake. Hypercalciuria is diagnosed when a value over 300 mg/day is identified. [6]
Urine tests with hypercalciuria should result in a 0.2 mg/mg ratio between calcium and creatinine. If calcium excreted in urine is measured to be lower than 0.07 mmol/kg after 24 hours, diet-dependent hypercalciuria can be deduced, and sodium levels in urine can confirm the result.
Increasing fluid intake to yield a urine output of greater than 2 liters a day can be advantageous for all patients with nephrocalcinosis. Patients with hypercalciuria can reduce calcium excretion by restricting animal protein, limiting sodium intake to less than 100 meq a day and being lax of potassium intake.
Elevated Calcitriol is suggestive of lymphoma, sarcoidosis, granulomatous disorders, and excessive calcitriol intake. Elevated calcifediol is suggestive of vitamin D or excessive calcifediol intake. [15] The normal range is 2.1–2.6 mmol/L (8.8–10.7 mg/dL, 4.3–5.2 mEq/L), with levels greater than 2.6 mmol/L defined as hypercalcaemia.
The amount of biologically active calcium varies with the level of serum albumin, a protein to which calcium is bound, and therefore levels of ionized calcium are better measures than a total calcium; however, one can correct a total calcium if the albumin level is known. [citation needed]
For those on low-calcium diets, there is normally 50–150 mg/24 hours, while those on a calcium-free diet will have 5–40 mg/24 hours. [1] The following reference ranges are for persons with average calcium intake (600–800 mg/day for adults):