Evaluation of the Relative Value of Diagnostic Tests in Hyperparathyroidism

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Abstract
Evaluation of the relative diagnostic value of serum calcium, serum phosphorus, urine calcium, and rate of urinary phosphate excretion (Cp) was made in 36 patients with proven hyper-parathyroidism, and the role of measurement of phosphate clearance was studied in those cases demonstrating minimal abnormality of serum calcium and phosphorus. Data indicated that serum calcium ranks first, phosphate clearance second, and serum phosphorus third, in diagnostic value. In 11 of the 36 patients, 6 of whom had no renal impairment, urine calcium was normal. Urinary phosphate excretion was elevated in 10 of these patients. In nearly half the patients, serum phosphorus was insufficiently depressed to be of any diagnostic aid, but several of these patients had high rates of urinary phosphate excretion. All cases demonstrated hypercalcemia, but this was minimal in 8. In these 8 patients, phosphate clearance was elevated to a significant degree in 5, and slightly elevated in 2.

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