Lein J W, Keane P M
Am J Kidney Dis. 1983 Jul;3(1):76-9. doi: 10.1016/s0272-6386(83)80015-8.
Twenty-two patients with idiopathic hypercalciuria were evaluated using an oral calcium loading test and compared with 20 normal controls. Following a 12-hour overnight fast, all subjects collected a two-hour urine sample after which they received 1 g elemental calcium as galacto-gluconate in milk. Two further two-hour urine collections were obtained consecutively following the oral calcium load. In the fasting state, 4 (18%) of the 22 patients had urinary calcium excretion (UCaE) above normal, but none had elevated iPTH or urinary cAMP values. After calcium loading, only 10 (45%) of the 22 patients had delta UCaE greater than controls (delta = difference in UCaE between third and first urine samples). We conclude that despite demonstrable differences between the mean values of patient and control groups with respect to the UCaE following calcium loading, the large overlap of values negates the clinical usefulness of such procedures in the routine management of individual patients. The definition of renal leak hypercalciuria based on a high fasting UCaE alone remains of uncertain significance.
对22例特发性高钙尿症患者进行了口服钙负荷试验评估，并与20名正常对照者进行了比较。在禁食12小时过夜后，所有受试者收集两小时的尿液样本，之后他们摄入1克作为半乳糖葡萄糖酸钙的元素钙，以牛奶形式服用。口服钙负荷后连续获得另外两个两小时的尿液样本。在禁食状态下，22例患者中有4例（18%）尿钙排泄（UCaE）高于正常，但无一例甲状旁腺激素（iPTH）升高或尿环磷酸腺苷（cAMP）值升高。钙负荷后，22例患者中只有10例（45%）的尿钙排泄差值（delta UCaE）大于对照组（delta = 第三次和第一次尿液样本之间的UCaE差值）。我们得出结论，尽管在钙负荷后患者组和对照组的UCaE平均值之间存在明显差异，但数值的大量重叠使得此类检查在个体患者的常规管理中失去了临床实用性。仅基于空腹时高UCaE来定义肾性漏出性高钙尿症的意义仍不确定。
