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In asymptomatic patients with mild CKD, PTH independent hypercalcemia, and hypercalciuria—after excluding common causes such as hyperparathyroidism, vitamin D abnormalities, multiple myeloma, thyroid disease, vitamin A excess, and antacid use—what is the next best step in evaluation?

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Mednet Member
Mednet Member
Endocrinology · Boston University School of Medicine

It would be helpful to have more information. What is the serum calcium, urinary calcium creatinine ratio, 1,25-dihydroxyvitamin D, 25-hydroxyvitamin D, urine NTX or serum CTX, phosphorus, P1NP or osteocalcin, creatinine clearance?

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