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Adjustment for body mass index and calcitrophic hormone levels improves the diagnostic accuracy of the spot urine calcium-to-creatinine ratio
Osteoporosis International, 09/22/09

Jones ANet al. – Calcium measurements from paired 24-hour and morning urine samples were compared; measurements correlated poorly. We developed a formula to correct random urine calcium levels. Corrected levels showed excellent agreement with 24-hour measurements. Until validation, providers should diagnose hypercalciuria using 24-hour tests.

Methods

During a 28-inpatient calcium absorption studies in 16 postmenopausal women, we simultaneously collected paired fasting morning and 24-hour urine specimens

Results

There was a moderate correlation between paired SUCCR and 24HUC specimens (r?=?0.57, p?=?0.002), but the SUCCR underestimated 24HUC by a mean of 83 mg (Bland–Altman
Hypercalciuria (24HUC >250 mg) was diagnosed in 8 specimens using the 24HUC, but only in two specimens using the SUCCR (25% sensitivity)
A regression model was developed to predict 24HUC using SUCCR, parathyroid hormone, body mass index, and 1,25(OH)2D; the model improved diagnostic sensitivity to 100% and decreased Bland–Altman bias of the SUCCR to +0.06 mg/kg/24-hour

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