Metabolic Evaluation: Place of the Calcium Load Test: How, When, For Whom, and Why?

Keller, Etienne Xavier; Coninck, Vincent De; Pietropaolo, Amelia; Somani, Bhaskar; Haymann, Jean‐Philippe; Daudon, Michel

doi:10.1016/j.euf.2020.12.019

Cited by 4 publications

(6 citation statements)

References 20 publications

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“…Those earlier studies revealed a whole spectrum of responsiveness and formulated the hypothesis that absolute autonomy of the parathyroid glands from serum calcium was quite unusual [16]. More recent studies tried to make a more subtle diff erentiation [12,[19][20][21]. In the study by [20].…”

Section: Discussionmentioning

confidence: 99%

“…The test was also used for diff erentiating autonomous secretion of PTH in PHPT from other secondary causes [11]. A number of studies have explored the test performance in diff erent forms of PHPT such as adenoma or multi-glandular hyperplasia [10,12]. The calcium load might be of signifi cant help in cases of assumed PHPT with unsuccessful localization studies or with concomitant reduction in the GFR.…”

Section: Introductionmentioning

confidence: 99%

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The Calcium Loading Test in Primary Hyperparathyroidism – Does it Provide Useful Information?

Boyanov

2022

Acta Medica Bulgarica

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Objective: to describe the results from intravenous calcium loads in patients with suspected PHPT. Methods: This was a retrospective cross-sectional study with inpatients’ data review. Baseline serum calcium, phosphates, magnesium, creatinine, alkaline phosphatase, beta-crosslinks were recorded. The calcium loading had been performed after an overnight fasting. Calcium gluconate 0.25 mmol/kg body weight (10 mg/kg) dissolved in 0.9% Sodium Chloride was infused intravenously for 3 hours. Blood samples for total serum calcium, phosphates and iPTH were drawn before and up to 60 minutes after the calcium load. The intact parathyroid hormone (iPTH) and 25(OH)-vitamin D were determined by electro-hemi-luminescence (Elecsys, Roche Diagnostics). The PTH inhibition rate in % (PTH-IR), the calcium increment, the ratio R (ΔPTH/ΔCalcium) and the product P (calcium X PTH at test end) were calculated. Results: 23 patients with PHPT had complete data from calcium loading tests. The PTH suppression was < 30% in 17.4% of the participants, 30% to 50% – in 21.7% and > 50% in the remaining 60.9%. One patient displayed PTH suppression > 75%. The Ratio R was < 4.0 in all but one patient. Product P was above 1100 mg/dl x pg/ml in 9 participants (39.1%). Sixteen patients (69.6%) had positive localization results from US or SPECT-CT. The level of PTH suppression was not related to any parameter except the volume of the suspected lesion. Conclusion: The calcium loading test was unable to differentiate the forms of PHPT. It did not add great value in the diagnostic work-up of PHPT.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Calcium Loading Test in Primary Hyperparathyroidism – Does it Provide Useful Information?

Boyanov

2022

Acta Medica Bulgarica

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“…Diagnosis can be made with ionized serum calcium, which is more representative of effective calcium stores than the total corrected serum calcium level [23,24]. The calcium loading test or Pak test could be used to complete this assessment and confirm NC-pHP [48].…”

Section: Discussionmentioning

confidence: 99%

Surgical management of MILD hyperparathyroidism

Lecourt

Creff

Coudert

et al. 2021

Eur Arch Otorhinolaryngol

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HAL is a multi-disciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

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“…For instance, hypercalciuria, hyperoxaluria, hyperuricosuria and hypocitraturia are common risk factors for stone prevalence and recurrence [1 ▪ ]. High-calcium excretion in urine or hypercalciuria (>200 mg/day on a constant restricted diet) [22 ▪ ] is related to some types of stone, such as calcium oxalate dihydrate (COD), carbapatite, and brushite [9 ▪ ]. Once we have this diagnosis, we will try to regulate the hypercalciuria by simple dietary measures, reducing sodium or proteins or increasing calcium intake (>1 g/day).…”

Section: What Is Included In the Extensive Analysis?mentioning

confidence: 99%

“…Nonetheless, in the case of persisting hypercalciuria, a calcium load test, or “Pak test”, would be helpful to identify absorptive hypercalciuria, seen in patients with normal bone mass and excessive intestinal calcium absorption, or resorptive hypercalciuria, seen in patients with potential calcium-phosphate disorder (i.e., hyperparathyroidism) or renal phosphate leak. Patients with resorptive hypercalciuria may have excessive bone resorption or an underlying unrelated bone disease, and both types of hypercalciuria are found to have increased intestinal calcium absorption [22 ▪ ]. In terms of hyperoxaluria, it is well associated with pure calcium stone formers [23], specifically with calcium oxalate monohydrate stones (whewellite) or stone type I, and with stone subtype IIb, a subtype that contains whewellite and COD stones (weddellite) [9 ▪ ].…”

Section: What Is Included In the Extensive Analysis?mentioning

confidence: 99%

Metabolic evaluation: is there really a future?

Traxer

Corrales

Sierra

2022

Current Opinion in Urology

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Purpose of reviewTo confirm the need for a metabolic evaluation in stone formers based on the latest information published in the last 24 months and in the current 2022 American and European urological guidelines. Recent findingsRecent studies suggest that urolithiasis prevalence has been increasing since 1990. Along with it, metabolic abnormalities that contribute to the development of kidney stones are also increasing, such as hyperuricosuria, hyperoxaluria, hypocitraturia, hypomagnesuria, hypocalciuria, hypophosphaturia, and hyperuricemia. Those abnormalities can only be detected through a metabolic evaluation in patients with stone disease.

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Metabolic Evaluation: Place of the Calcium Load Test: How, When, For Whom, and Why?

Cited by 4 publications

References 20 publications

The Calcium Loading Test in Primary Hyperparathyroidism – Does it Provide Useful Information?

The Calcium Loading Test in Primary Hyperparathyroidism – Does it Provide Useful Information?

Surgical management of MILD hyperparathyroidism

Metabolic evaluation: is there really a future?

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