Calcium in urine
Test Description
Calcium (Ca++) plays important roles in muscle contraction, heart function, transmission
of nerve impulses, and clotting of the blood. Only 1% to 2% of the calcium
is in the blood; the remaining 98% to 99% is stored in the teeth and bones, which
can be released as needed to maintain normal serum calcium levels. Most of the
calcium excreted from the body is lost in stool; 99% of the calcium filtered by the
kidneys is reabsorbed. When increased levels of urinary calcium do exist, it is usually
due to elevated serum calcium levels. Urinary calcium is used primarily to evaluate
parathyroid function and the effects of Vitamin D.
ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
Normal Values: 0–300 mg/day (0–7.5 mmol/day SI units)
Increased Decreased
Breast cancer Hypoparathyroidism
Cushing’s syndrome Malabsorption
Fanconi syndrome Renal osteodystrophy
Glucocorticoid excess Vitamin D deficiency
Hyperthyroidism
Hyperparathyroidism
Lung cancer
Metastatic cancer
Milk-alkali syndrome
Multiple myeloma
Osteoporosis
Paget’s disease
Renal tubular acidosis
Sarcoidosis
Vitamin D intoxication
Wilson’s disease
ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
Contributing Factors to Abnormal Values
• Urinary calcium levels are higher immediately after meals.
• False-negative results may occur with alkaline urine.
• Drugs which may increase urinary calcium levels: ammonium chloride, androgens,
anabolic steroids, antacids, anticonvulsants, cholestyramine, furosemide, mercurial
diuretics, parathyroid hormone, phosphates, vitamin D.
• Drugs which may decrease urinary calcium levels: corticosteroids, aspirin,
indomethacin, oral contraceptives, thiazide diuretics.
ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
Interventions/Implications
Pretest
• Explain 24-hour urine collection procedure to the patient.
Calcium, Urine
Test Description
Calcium (Ca++) plays important roles in muscle contraction, heart function, transmission
of nerve impulses, and clotting of the blood. Only 1% to 2% of the calcium
is in the blood; the remaining 98% to 99% is stored in the teeth and bones, which
can be released as needed to maintain normal serum calcium levels. Most of the
calcium excreted from the body is lost in stool; 99% of the calcium filtered by the
kidneys is reabsorbed. When increased levels of urinary calcium do exist, it is usually
due to elevated serum calcium levels. Urinary calcium is used primarily to evaluate
parathyroid function and the effects of Vitamin D.
• Stress the importance of saving all urine in the 24-hour period. Instruct the patient to
avoid contaminating the urine with toilet paper or feces.
• Inform the patient of the presence of a preservative in the collection bottle.
Procedure
• Obtain the proper container containing HCl as preservative from the laboratory.
• Begin the testing period in the morning after the patient’s first voiding, which is
discarded.
• Timing of the 24-hour period begins at the time the first voiding is discarded.
• All urine for the next 24 hours is collected in the container, which is to be kept refrigerated
or on ice.
• If any urine is accidentally discarded during the 24-hour period, the test must be discontinued
and a new test begun.
• The ending time of the 24-hour collection period should be posted in the patient’s room.
• Gloves are worn whenever dealing with the specimen collection.
Posttest
• At the end of the 24-hour collection period, label and send the urine container to the laboratory
as soon as possible.
• Report abnormal findings to the primary care provider.
Calcium (Ca++) plays important roles in muscle contraction, heart function, transmission
of nerve impulses, and clotting of the blood. Only 1% to 2% of the calcium
is in the blood; the remaining 98% to 99% is stored in the teeth and bones, which
can be released as needed to maintain normal serum calcium levels. Most of the
calcium excreted from the body is lost in stool; 99% of the calcium filtered by the
kidneys is reabsorbed. When increased levels of urinary calcium do exist, it is usually
due to elevated serum calcium levels. Urinary calcium is used primarily to evaluate
parathyroid function and the effects of Vitamin D.
ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
Normal Values: 0–300 mg/day (0–7.5 mmol/day SI units)
ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
Possible Meanings of Abnormal ValuesIncreased Decreased
Breast cancer Hypoparathyroidism
Cushing’s syndrome Malabsorption
Fanconi syndrome Renal osteodystrophy
Glucocorticoid excess Vitamin D deficiency
Hyperthyroidism
Hyperparathyroidism
Lung cancer
Metastatic cancer
Milk-alkali syndrome
Multiple myeloma
Osteoporosis
Paget’s disease
Renal tubular acidosis
Sarcoidosis
Vitamin D intoxication
Wilson’s disease
ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
Contributing Factors to Abnormal Values
• Urinary calcium levels are higher immediately after meals.
• False-negative results may occur with alkaline urine.
• Drugs which may increase urinary calcium levels: ammonium chloride, androgens,
anabolic steroids, antacids, anticonvulsants, cholestyramine, furosemide, mercurial
diuretics, parathyroid hormone, phosphates, vitamin D.
• Drugs which may decrease urinary calcium levels: corticosteroids, aspirin,
indomethacin, oral contraceptives, thiazide diuretics.
ــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ
Interventions/Implications
Pretest
• Explain 24-hour urine collection procedure to the patient.
Calcium, Urine
Test Description
Calcium (Ca++) plays important roles in muscle contraction, heart function, transmission
of nerve impulses, and clotting of the blood. Only 1% to 2% of the calcium
is in the blood; the remaining 98% to 99% is stored in the teeth and bones, which
can be released as needed to maintain normal serum calcium levels. Most of the
calcium excreted from the body is lost in stool; 99% of the calcium filtered by the
kidneys is reabsorbed. When increased levels of urinary calcium do exist, it is usually
due to elevated serum calcium levels. Urinary calcium is used primarily to evaluate
parathyroid function and the effects of Vitamin D.
• Stress the importance of saving all urine in the 24-hour period. Instruct the patient to
avoid contaminating the urine with toilet paper or feces.
• Inform the patient of the presence of a preservative in the collection bottle.
Procedure
• Obtain the proper container containing HCl as preservative from the laboratory.
• Begin the testing period in the morning after the patient’s first voiding, which is
discarded.
• Timing of the 24-hour period begins at the time the first voiding is discarded.
• All urine for the next 24 hours is collected in the container, which is to be kept refrigerated
or on ice.
• If any urine is accidentally discarded during the 24-hour period, the test must be discontinued
and a new test begun.
• The ending time of the 24-hour collection period should be posted in the patient’s room.
• Gloves are worn whenever dealing with the specimen collection.
Posttest
• At the end of the 24-hour collection period, label and send the urine container to the laboratory
as soon as possible.
• Report abnormal findings to the primary care provider.
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