Fractional Excretion of Calcium (FECa) Calculator<\/title>\n <style>\n .fecalculator-container {\n max-width: 550px;\n margin: 20px auto;\n padding: 20px;\n border: 1px solid #ccc;\n border-radius: 8px;\n background: #fafafa;\n font-family: Arial, sans-serif;\n }\n .fecalculator-container h2 {\n text-align: center;\n background: #444;\n color: #fff;\n padding: 10px;\n border-radius: 4px;\n margin-top: 0;\n }\n .fecalculator-row {\n margin-bottom: 15px;\n }\n .fecalculator-row label {\n display: block;\n font-weight: bold;\n margin-bottom: 5px;\n }\n .fecalculator-row input, \n .fecalculator-row select {\n width: 100%;\n padding: 8px;\n box-sizing: border-box;\n }\n .fecalculator-buttons {\n margin-top: 20px;\n display: flex;\n gap: 10px;\n }\n .fecalculator-buttons button {\n padding: 10px 20px;\n background: #0073aa;\n border: none;\n color: #fff;\n border-radius: 4px;\n cursor: pointer;\n }\n .fecalculator-buttons button:hover {\n background: #005c86;\n }\n .fecalculator-results {\n margin-top: 20px;\n background: #f9f9f9;\n padding: 15px;\n border-radius: 6px;\n display: none; \/* hidden by default *\/\n }\n .fecalculator-results p {\n margin: 5px 0;\n }\n .error-message {\n color: #b94a48;\n font-weight: bold;\n margin-bottom: 10px;\n }\n .highlight {\n font-weight: bold;\n color: #d9534f;\n }\n .references {\n font-size: 0.9em;\n margin-top: 20px;\n }\n .references p {\n margin: 4px 0;\n line-height: 1.3;\n }\n <\/style>\n<\/head>\n<body data-rsssl=1>\n\n<div class=\"fecalculator-container\">\n <h2>Fractional Excretion of Calcium (FECa) Calculator<\/h2>\n\n \n <div class=\"fecalculator-row\">\n <label for=\"uCa\">Urine Calcium<\/label>\n <input type=\"number\" id=\"uCa\" placeholder=\"Enter Urine Ca\" step=\"any\">\n <select id=\"uCaUnit\">\n <option value=\"mg\/dL\">mg\/dL<\/option>\n <option value=\"mmol\/L\">mmol\/L<\/option>\n <\/select>\n <\/div>\n\n \n <div class=\"fecalculator-row\">\n <label for=\"sCa\">Serum Calcium<\/label>\n <input type=\"number\" id=\"sCa\" placeholder=\"Enter Serum Ca\" step=\"any\">\n <select id=\"sCaUnit\">\n <option value=\"mg\/dL\">mg\/dL<\/option>\n <option value=\"mmol\/L\">mmol\/L<\/option>\n <\/select>\n <\/div>\n\n \n <div class=\"fecalculator-row\">\n <label for=\"uCr\">Urine Creatinine<\/label>\n <input type=\"number\" id=\"uCr\" placeholder=\"Enter Urine Creatinine\" step=\"any\">\n <select id=\"uCrUnit\">\n <option value=\"mg\/dL\">mg\/dL<\/option>\n <option value=\"mmol\/L\">mmol\/L<\/option>\n <\/select>\n <\/div>\n\n \n <div class=\"fecalculator-row\">\n <label for=\"sCr\">Serum Creatinine<\/label>\n <input type=\"number\" id=\"sCr\" placeholder=\"Enter Serum Creatinine\" step=\"any\">\n <select id=\"sCrUnit\">\n <option value=\"mg\/dL\">mg\/dL<\/option>\n <option value=\"mmol\/L\">mmol\/L<\/option>\n <\/select>\n <\/div>\n\n \n <div class=\"fecalculator-buttons\">\n <button onclick=\"calcFECa()\">Calculate FECa<\/button>\n <button onclick=\"resetForm()\">Reset<\/button>\n <\/div>\n\n \n <div id=\"errorBox\" class=\"error-message\"><\/div>\n\n \n <div class=\"fecalculator-results\" id=\"fecalculatorResults\">\n <p><strong>Fractional Excretion of Calcium (FECa):<\/strong> \n <span id=\"fecalculatorValue\" class=\"highlight\">—<\/span><\/p>\n <p id=\"fecalculatorInterpretation\"><\/p>\n <\/div>\n\n \n <div class=\"Important Notice\">\n <p><strong>Important Notice for Errors<\/strong><\/p>\n <p>Urine calcium and creatinine need to be entered in the same conventional units (e.g. mg\/dL, mmol\/24hrs). If they are not the same, convert one of them to maintain consistency<\/p>\n <p>Serum calcium and creatinine need to be entered in the same conventional units (e.g. mg\/dL, mmol\/L.). If they are not the same, convert one of them to maintain consistency.<\/p>\n <p>Acceptable for serum units (e.g. mg\/dL) to be different from urine units (e.g. mmol), but both serum and urine parameters should still be using the same system (US or SI)<\/p>\n<p>Urine Creatinine (Please remember to change gm per 24hrs to mg per 24hrs by multiplying by 1000, for some laboratory reports)<\/p>\n <\/div>\n<div class=\"references\">\n <p><strong>References:<\/strong><\/p>\n <p>Bilezikian JP. <em>Primary Hyperparathyroidism<\/em>. J Clin Endocrinol Metab. 2018;103(11):3993-4004.<\/p>\n <p>Christensen SE, et al. <em>Familial Hypocalciuric Hypercalcaemia: a review<\/em>. Curr Opin Endocrinol Diabetes Obes. 2011;18(6):359-70.<\/p>\n <\/div>\n<\/div>\n\n<script>\nfunction calcFECa() {\n \/\/ Clear any previous error\n document.getElementById(\"errorBox\").textContent = \"\";\n document.getElementById(\"fecalculatorResults\").style.display = \"none\";\n\n \/\/ Grab values\n let uCa = parseFloat(document.getElementById(\"uCa\").value);\n let sCa = parseFloat(document.getElementById(\"sCa\").value);\n let uCr = parseFloat(document.getElementById(\"uCr\").value);\n let sCr = parseFloat(document.getElementById(\"sCr\").value);\n\n let uCaUnit = document.getElementById(\"uCaUnit\").value;\n let sCaUnit = document.getElementById(\"sCaUnit\").value;\n let uCrUnit = document.getElementById(\"uCrUnit\").value;\n let sCrUnit = document.getElementById(\"sCrUnit\").value;\n\n \/\/ Basic numeric checks\n if (isNaN(uCa) || isNaN(sCa) || isNaN(uCr) || isNaN(sCr)) {\n showError(\"All values must be numeric to calculate FECa.\");\n return;\n }\n\n \/\/ Urine Ca & Urine Creatinine must share the same unit (either mg\/dL or mmol\/L)\n if (uCaUnit !== uCrUnit) {\n showError(\"Urine Calcium and Urine Creatinine must both be in mg\/dL OR both be in mmol\/L.\");\n return;\n }\n \/\/ Serum Ca & Serum Creatinine must share the same unit (either mg\/dL or mmol\/L)\n if (sCaUnit !== sCrUnit) {\n showError(\"Serum Calcium and Serum Creatinine must both be in mg\/dL OR both be in mmol\/L.\");\n return;\n }\n\n \/\/ If the units match within urine pair and serum pair, \n \/\/ we can directly do: FECa = ( (U_Ca \/ S_Ca) \/ (U_Cr \/ S_Cr) )\n\n let ratioCalcium = (uCa \/ sCa);\n let ratioCreatinine = (uCr \/ sCr);\n let fecalVal = ratioCalcium \/ ratioCreatinine; \/\/ dimensionless\n\n \/\/ Format to 3 decimals for better resolution around 0.01\n let fecalValStr = fecalVal.toFixed(3);\n\n \/\/ Display result\n document.getElementById(\"fecalculatorValue\").textContent = fecalValStr;\n document.getElementById(\"fecalculatorResults\").style.display = \"block\";\n\n \/\/ Interpretation: < 0.01 => FHH; \u2265 0.01 => Primary hyperparathyroidism\n let interpretation = \"\";\n if (fecalVal < 0.01) {\n interpretation = \"FECa < 0.01 \u2192 Familial Hypocalciuric Hypercalcemia (FHH) more likely.\";\n } else {\n interpretation = \"FECa \u2265 0.01 \u2192 Primary Hyperparathyroidism more likely.\";\n }\n document.getElementById(\"fecalculatorInterpretation\").textContent = interpretation;\n}\n\nfunction showError(msg) {\n document.getElementById(\"errorBox\").textContent = msg;\n}\n\n\/\/ Reset the form\nfunction resetForm() {\n document.getElementById(\"uCa\").value = \"\";\n document.getElementById(\"sCa\").value = \"\";\n document.getElementById(\"uCr\").value = \"\";\n document.getElementById(\"sCr\").value = \"\";\n\n document.getElementById(\"uCaUnit\").value = \"mg\/dL\";\n document.getElementById(\"sCaUnit\").value = \"mg\/dL\";\n document.getElementById(\"uCrUnit\").value = \"mg\/dL\";\n document.getElementById(\"sCrUnit\").value = \"mg\/dL\";\n\n document.getElementById(\"errorBox\").textContent = \"\";\n document.getElementById(\"fecalculatorValue\").textContent = \"--\";\n document.getElementById(\"fecalculatorInterpretation\").textContent = \"\";\n document.getElementById(\"fecalculatorResults\").style.display = \"none\";\n}\n<\/script>\n\n<\/body>\n<\/html>\n\n\n<h2>Interpretation of FECa results<\/h2>\n<p><strong>> 0.01:<\/strong> <strong>Familial Hypocalciuric Hypercalcaemia (FHH) is unlikely.<\/strong> The patient most likely has primary hyperparathyroidism<\/p>\n<p><strong>< 0.01:<\/strong> <strong>Familial Hypocalciuric Hypercalcaemia (FHH) is likely<\/strong>. It is however important to rule out other causes of low urine calcium excretion such as hypovitaminosis D, low salt intake, low calcium intake, significant renal disease, lithium or thiazide diuretic exposure<\/p>\n<h2>Differential diagnoses of PTH dependent hypercalcemia<\/h2>\n<p><img decoding=\"async\" title=\"\" src=\"https:\/\/www.myendoconsult.com\/learn\/wp-content\/uploads\/feca-pocket-card-min.png\" alt=\"FECA Estimation infographic\" \/><\/p>\n<p>Download a high-resolution version (<a href=\"https:\/\/www.myendoconsult.com\/learn\/wp-content\/uploads\/FECA-high-res-format-in-pdf.pdf\">pdf print version<\/a>) or picture format (<a href=\"https:\/\/www.myendoconsult.com\/learn\/wp-content\/uploads\/FECA-high-res-format-in-png.png\">PNG<\/a>)<\/p>\n<p>The diagnostic umbrella for <strong>PTH-dependent hypercalcemia<\/strong> is broad, with most cases representing primary hyperparathyroidism (PHPT), after excluding other causes of hyperparathyroidism. Although a relatively rare cause of PTH-dependent hypercalcemia, misdiagnosis of a case of <strong>FHH<\/strong> may lead to inadvertent and possibly harmful parathyroidectomy.<\/p>\n<p>FHH is characterized by a triad of hypercalcemia, inappropriately normal or elevated parathyroid hormone, and a low fractional excretion of calcium (FECa) < 0.01. A diagnostic threshold of FECa less than 0.01 has traditionally been accepted for distinguishing between familial hypocalciuric hypercalcemia and primary hyperparathyroidism. <b>FECa in a \u201cgray zone\u201d between 0.01 and 0.02<\/b> has been reported in some subjects with FHH; thus, using a strict cutoff of 0.01 may lead to some cases of FHH being missed. Indeed, the use of a higher threshold of 0.02 was shown in a retrospective study to have a diagnostic sensitivity of 98% for FHH.<\/p>\n<h2>References<\/h2>\n<ul>\n<li>J.P. Bilezikian Primary hyperparathyroidism <a href=\"https:\/\/doi.org\/10.1210\/jc.2018-01225\" target=\"_blank\" rel=\"noopener\">J Clin Endocrinol Metab, 103 (11) (2018 Nov 1), pp. 3993-4004<\/a><\/li>\n<li>C. Brachet, E. Boros, S. Tenoutasse, W. Lissens, G. Andry, P. Martin, et al. Association of parathyroid adenoma and familial hypocalciuric hypercalcaemia in a teenager <a href=\"https:\/\/doi.org\/10.1530\/eje-09-0257\" target=\"_blank\" rel=\"noopener\">Eur J Endocrinol, 161 (1) (2009 Jul 1), pp. 207-210<\/a><\/li>\n<li>J.S. Bhangu, A. Selberherr, L. Brammen, C. Scheuba, P. Riss\u00a0Efficacy of calcium excretion and calcium\/creatinine clearance ratio in the differential diagnosis of familial hypocalciuric hypercalcemia and primary hyperparathyroidism\u00a0<a href=\"https:\/\/doi.org\/10.1002\/hed.25568\" target=\"_blank\" rel=\"noopener\">Head Neck, 41 (5) (2019), pp. 1372-1378<\/a><\/li>\n<li>J.P. Bilezikian, M.L. Brandi, R. Eastell, S.J. Silverberg, R. Udelsman, C. Marcocci, et al.\u00a0Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the fourth international workshop <a href=\"https:\/\/doi.org\/10.1210\/jc.2014-1413\" target=\"_blank\" rel=\"noopener\">J Clin Endocrinol Metab, 99 (10) (2014 Oct), pp. 3561-3569<\/a><\/li>\n<li>S.E. Christensen, P.H. Nissen, P. Vestergaard, L. Mosekilde Familial hypocalciuric hypercalcaemia: a review Curr Opin Endocrinol Diabetes Obes, 18 (6) (2011 Dec), pp. 359-370<\/li>\n<\/ul>\n\n","protected":false},"excerpt":{"rendered":"<p>Fractional Excretion of Calcium (FECa) Calculator Fractional Excretion of Calcium (FECa) Calculator Urine Calcium mg\/dLmmol\/L Serum Calcium mg\/dLmmol\/L Urine Creatinine mg\/dLmmol\/L Serum Creatinine mg\/dLmmol\/L Calculate FECa Reset Fractional Excretion of Calcium (FECa): — Important Notice for Errors Urine calcium and creatinine need to be entered in the same conventional units (e.g. mg\/dL, mmol\/24hrs). If they […]<\/p>\n","protected":false},"author":1,"featured_media":2336031,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[100],"tags":[],"class_list":["post-599054","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-endocalculator","post-wrapper","thrv_wrapper"],"_links":{"self":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/599054","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/comments?post=599054"}],"version-history":[{"count":163,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/599054\/revisions"}],"predecessor-version":[{"id":4421945,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/599054\/revisions\/4421945"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media\/2336031"}],"wp:attachment":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media?parent=599054"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/categories?post=599054"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/tags?post=599054"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}

{"id":599054,"date":"2022-01-08T12:18:58","date_gmt":"2022-01-08T17:18:58","guid":{"rendered":"https:\/\/myendoconsult.com\/learn\/?p=599054"},"modified":"2024-12-26T07:22:11","modified_gmt":"2024-12-26T13:22:11","slug":"fractional-excretion-of-calcium-calculator","status":"publish","type":"post","link":"https:\/\/myendoconsult.com\/learn\/fractional-excretion-of-calcium-calculator\/","title":{"rendered":"Fractional Excretion of Calcium (FeCa) Calculator"},"content":{"rendered":"\n\n\n\n \n Fractional Excretion of Calcium (FECa) Calculator<\/title>\n <style>\n .fecalculator-container {\n max-width: 550px;\n margin: 20px auto;\n padding: 20px;\n border: 1px solid #ccc;\n border-radius: 8px;\n background: #fafafa;\n font-family: Arial, sans-serif;\n }\n .fecalculator-container h2 {\n text-align: center;\n background: #444;\n color: #fff;\n padding: 10px;\n border-radius: 4px;\n margin-top: 0;\n }\n .fecalculator-row {\n margin-bottom: 15px;\n }\n .fecalculator-row label {\n display: block;\n font-weight: bold;\n margin-bottom: 5px;\n }\n .fecalculator-row input, \n .fecalculator-row select {\n width: 100%;\n padding: 8px;\n box-sizing: border-box;\n }\n .fecalculator-buttons {\n margin-top: 20px;\n display: flex;\n gap: 10px;\n }\n .fecalculator-buttons button {\n padding: 10px 20px;\n background: #0073aa;\n border: none;\n color: #fff;\n border-radius: 4px;\n cursor: pointer;\n }\n .fecalculator-buttons button:hover {\n background: #005c86;\n }\n .fecalculator-results {\n margin-top: 20px;\n background: #f9f9f9;\n padding: 15px;\n border-radius: 6px;\n display: none; \/* hidden by default *\/\n }\n .fecalculator-results p {\n margin: 5px 0;\n }\n .error-message {\n color: #b94a48;\n font-weight: bold;\n margin-bottom: 10px;\n }\n .highlight {\n font-weight: bold;\n color: #d9534f;\n }\n .references {\n font-size: 0.9em;\n margin-top: 20px;\n }\n .references p {\n margin: 4px 0;\n line-height: 1.3;\n }\n <\/style>\n<\/head>\n<body data-rsssl=1>\n\n<div class=\"fecalculator-container\">\n <h2>Fractional Excretion of Calcium (FECa) Calculator<\/h2>\n\n \n <div class=\"fecalculator-row\">\n <label for=\"uCa\">Urine Calcium<\/label>\n <input type=\"number\" id=\"uCa\" placeholder=\"Enter Urine Ca\" step=\"any\">\n <select id=\"uCaUnit\">\n <option value=\"mg\/dL\">mg\/dL<\/option>\n <option value=\"mmol\/L\">mmol\/L<\/option>\n <\/select>\n <\/div>\n\n \n <div class=\"fecalculator-row\">\n <label for=\"sCa\">Serum Calcium<\/label>\n <input type=\"number\" id=\"sCa\" placeholder=\"Enter Serum Ca\" step=\"any\">\n <select id=\"sCaUnit\">\n <option value=\"mg\/dL\">mg\/dL<\/option>\n <option value=\"mmol\/L\">mmol\/L<\/option>\n <\/select>\n <\/div>\n\n \n <div class=\"fecalculator-row\">\n <label for=\"uCr\">Urine Creatinine<\/label>\n <input type=\"number\" id=\"uCr\" placeholder=\"Enter Urine Creatinine\" step=\"any\">\n <select id=\"uCrUnit\">\n <option value=\"mg\/dL\">mg\/dL<\/option>\n <option value=\"mmol\/L\">mmol\/L<\/option>\n <\/select>\n <\/div>\n\n \n <div class=\"fecalculator-row\">\n <label for=\"sCr\">Serum Creatinine<\/label>\n <input type=\"number\" id=\"sCr\" placeholder=\"Enter Serum Creatinine\" step=\"any\">\n <select id=\"sCrUnit\">\n <option value=\"mg\/dL\">mg\/dL<\/option>\n <option value=\"mmol\/L\">mmol\/L<\/option>\n <\/select>\n <\/div>\n\n \n <div class=\"fecalculator-buttons\">\n <button onclick=\"calcFECa()\">Calculate FECa<\/button>\n <button onclick=\"resetForm()\">Reset<\/button>\n <\/div>\n\n \n <div id=\"errorBox\" class=\"error-message\"><\/div>\n\n \n <div class=\"fecalculator-results\" id=\"fecalculatorResults\">\n <p><strong>Fractional Excretion of Calcium (FECa):<\/strong> \n <span id=\"fecalculatorValue\" class=\"highlight\">—<\/span><\/p>\n <p id=\"fecalculatorInterpretation\"><\/p>\n <\/div>\n\n \n <div class=\"Important Notice\">\n <p><strong>Important Notice for Errors<\/strong><\/p>\n <p>Urine calcium and creatinine need to be entered in the same conventional units (e.g. mg\/dL, mmol\/24hrs). If they are not the same, convert one of them to maintain consistency<\/p>\n <p>Serum calcium and creatinine need to be entered in the same conventional units (e.g. mg\/dL, mmol\/L.). If they are not the same, convert one of them to maintain consistency.<\/p>\n <p>Acceptable for serum units (e.g. mg\/dL) to be different from urine units (e.g. mmol), but both serum and urine parameters should still be using the same system (US or SI)<\/p>\n<p>Urine Creatinine (Please remember to change gm per 24hrs to mg per 24hrs by multiplying by 1000, for some laboratory reports)<\/p>\n <\/div>\n<div class=\"references\">\n <p><strong>References:<\/strong><\/p>\n <p>Bilezikian JP. <em>Primary Hyperparathyroidism<\/em>. J Clin Endocrinol Metab. 2018;103(11):3993-4004.<\/p>\n <p>Christensen SE, et al. <em>Familial Hypocalciuric Hypercalcaemia: a review<\/em>. Curr Opin Endocrinol Diabetes Obes. 2011;18(6):359-70.<\/p>\n <\/div>\n<\/div>\n\n<script>\nfunction calcFECa() {\n \/\/ Clear any previous error\n document.getElementById(\"errorBox\").textContent = \"\";\n document.getElementById(\"fecalculatorResults\").style.display = \"none\";\n\n \/\/ Grab values\n let uCa = parseFloat(document.getElementById(\"uCa\").value);\n let sCa = parseFloat(document.getElementById(\"sCa\").value);\n let uCr = parseFloat(document.getElementById(\"uCr\").value);\n let sCr = parseFloat(document.getElementById(\"sCr\").value);\n\n let uCaUnit = document.getElementById(\"uCaUnit\").value;\n let sCaUnit = document.getElementById(\"sCaUnit\").value;\n let uCrUnit = document.getElementById(\"uCrUnit\").value;\n let sCrUnit = document.getElementById(\"sCrUnit\").value;\n\n \/\/ Basic numeric checks\n if (isNaN(uCa) || isNaN(sCa) || isNaN(uCr) || isNaN(sCr)) {\n showError(\"All values must be numeric to calculate FECa.\");\n return;\n }\n\n \/\/ Urine Ca & Urine Creatinine must share the same unit (either mg\/dL or mmol\/L)\n if (uCaUnit !== uCrUnit) {\n showError(\"Urine Calcium and Urine Creatinine must both be in mg\/dL OR both be in mmol\/L.\");\n return;\n }\n \/\/ Serum Ca & Serum Creatinine must share the same unit (either mg\/dL or mmol\/L)\n if (sCaUnit !== sCrUnit) {\n showError(\"Serum Calcium and Serum Creatinine must both be in mg\/dL OR both be in mmol\/L.\");\n return;\n }\n\n \/\/ If the units match within urine pair and serum pair, \n \/\/ we can directly do: FECa = ( (U_Ca \/ S_Ca) \/ (U_Cr \/ S_Cr) )\n\n let ratioCalcium = (uCa \/ sCa);\n let ratioCreatinine = (uCr \/ sCr);\n let fecalVal = ratioCalcium \/ ratioCreatinine; \/\/ dimensionless\n\n \/\/ Format to 3 decimals for better resolution around 0.01\n let fecalValStr = fecalVal.toFixed(3);\n\n \/\/ Display result\n document.getElementById(\"fecalculatorValue\").textContent = fecalValStr;\n document.getElementById(\"fecalculatorResults\").style.display = \"block\";\n\n \/\/ Interpretation: < 0.01 => FHH; \u2265 0.01 => Primary hyperparathyroidism\n let interpretation = \"\";\n if (fecalVal < 0.01) {\n interpretation = \"FECa < 0.01 \u2192 Familial Hypocalciuric Hypercalcemia (FHH) more likely.\";\n } else {\n interpretation = \"FECa \u2265 0.01 \u2192 Primary Hyperparathyroidism more likely.\";\n }\n document.getElementById(\"fecalculatorInterpretation\").textContent = interpretation;\n}\n\nfunction showError(msg) {\n document.getElementById(\"errorBox\").textContent = msg;\n}\n\n\/\/ Reset the form\nfunction resetForm() {\n document.getElementById(\"uCa\").value = \"\";\n document.getElementById(\"sCa\").value = \"\";\n document.getElementById(\"uCr\").value = \"\";\n document.getElementById(\"sCr\").value = \"\";\n\n document.getElementById(\"uCaUnit\").value = \"mg\/dL\";\n document.getElementById(\"sCaUnit\").value = \"mg\/dL\";\n document.getElementById(\"uCrUnit\").value = \"mg\/dL\";\n document.getElementById(\"sCrUnit\").value = \"mg\/dL\";\n\n document.getElementById(\"errorBox\").textContent = \"\";\n document.getElementById(\"fecalculatorValue\").textContent = \"--\";\n document.getElementById(\"fecalculatorInterpretation\").textContent = \"\";\n document.getElementById(\"fecalculatorResults\").style.display = \"none\";\n}\n<\/script>\n\n<\/body>\n<\/html>\n\n\n<h2>Interpretation of FECa results<\/h2>\n<p><strong>> 0.01:<\/strong> <strong>Familial Hypocalciuric Hypercalcaemia (FHH) is unlikely.<\/strong> The patient most likely has primary hyperparathyroidism<\/p>\n<p><strong>< 0.01:<\/strong> <strong>Familial Hypocalciuric Hypercalcaemia (FHH) is likely<\/strong>. It is however important to rule out other causes of low urine calcium excretion such as hypovitaminosis D, low salt intake, low calcium intake, significant renal disease, lithium or thiazide diuretic exposure<\/p>\n<h2>Differential diagnoses of PTH dependent hypercalcemia<\/h2>\n<p><img decoding=\"async\" title=\"\" src=\"https:\/\/www.myendoconsult.com\/learn\/wp-content\/uploads\/feca-pocket-card-min.png\" alt=\"FECA Estimation infographic\" \/><\/p>\n<p>Download a high-resolution version (<a href=\"https:\/\/www.myendoconsult.com\/learn\/wp-content\/uploads\/FECA-high-res-format-in-pdf.pdf\">pdf print version<\/a>) or picture format (<a href=\"https:\/\/www.myendoconsult.com\/learn\/wp-content\/uploads\/FECA-high-res-format-in-png.png\">PNG<\/a>)<\/p>\n<p>The diagnostic umbrella for <strong>PTH-dependent hypercalcemia<\/strong> is broad, with most cases representing primary hyperparathyroidism (PHPT), after excluding other causes of hyperparathyroidism. Although a relatively rare cause of PTH-dependent hypercalcemia, misdiagnosis of a case of <strong>FHH<\/strong> may lead to inadvertent and possibly harmful parathyroidectomy.<\/p>\n<p>FHH is characterized by a triad of hypercalcemia, inappropriately normal or elevated parathyroid hormone, and a low fractional excretion of calcium (FECa) < 0.01. A diagnostic threshold of FECa less than 0.01 has traditionally been accepted for distinguishing between familial hypocalciuric hypercalcemia and primary hyperparathyroidism. <b>FECa in a \u201cgray zone\u201d between 0.01 and 0.02<\/b> has been reported in some subjects with FHH; thus, using a strict cutoff of 0.01 may lead to some cases of FHH being missed. Indeed, the use of a higher threshold of 0.02 was shown in a retrospective study to have a diagnostic sensitivity of 98% for FHH.<\/p>\n<h2>References<\/h2>\n<ul>\n<li>J.P. Bilezikian Primary hyperparathyroidism <a href=\"https:\/\/doi.org\/10.1210\/jc.2018-01225\" target=\"_blank\" rel=\"noopener\">J Clin Endocrinol Metab, 103 (11) (2018 Nov 1), pp. 3993-4004<\/a><\/li>\n<li>C. Brachet, E. Boros, S. Tenoutasse, W. Lissens, G. Andry, P. Martin, et al. Association of parathyroid adenoma and familial hypocalciuric hypercalcaemia in a teenager <a href=\"https:\/\/doi.org\/10.1530\/eje-09-0257\" target=\"_blank\" rel=\"noopener\">Eur J Endocrinol, 161 (1) (2009 Jul 1), pp. 207-210<\/a><\/li>\n<li>J.S. Bhangu, A. Selberherr, L. Brammen, C. Scheuba, P. Riss\u00a0Efficacy of calcium excretion and calcium\/creatinine clearance ratio in the differential diagnosis of familial hypocalciuric hypercalcemia and primary hyperparathyroidism\u00a0<a href=\"https:\/\/doi.org\/10.1002\/hed.25568\" target=\"_blank\" rel=\"noopener\">Head Neck, 41 (5) (2019), pp. 1372-1378<\/a><\/li>\n<li>J.P. Bilezikian, M.L. Brandi, R. Eastell, S.J. Silverberg, R. Udelsman, C. Marcocci, et al.\u00a0Guidelines for the management of asymptomatic primary hyperparathyroidism: summary statement from the fourth international workshop <a href=\"https:\/\/doi.org\/10.1210\/jc.2014-1413\" target=\"_blank\" rel=\"noopener\">J Clin Endocrinol Metab, 99 (10) (2014 Oct), pp. 3561-3569<\/a><\/li>\n<li>S.E. Christensen, P.H. Nissen, P. Vestergaard, L. Mosekilde Familial hypocalciuric hypercalcaemia: a review Curr Opin Endocrinol Diabetes Obes, 18 (6) (2011 Dec), pp. 359-370<\/li>\n<\/ul>\n\n","protected":false},"excerpt":{"rendered":"<p>Fractional Excretion of Calcium (FECa) Calculator Fractional Excretion of Calcium (FECa) Calculator Urine Calcium mg\/dLmmol\/L Serum Calcium mg\/dLmmol\/L Urine Creatinine mg\/dLmmol\/L Serum Creatinine mg\/dLmmol\/L Calculate FECa Reset Fractional Excretion of Calcium (FECa): — Important Notice for Errors Urine calcium and creatinine need to be entered in the same conventional units (e.g. mg\/dL, mmol\/24hrs). If they […]<\/p>\n","protected":false},"author":1,"featured_media":2336031,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[100],"tags":[],"class_list":["post-599054","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-endocalculator","post-wrapper","thrv_wrapper"],"_links":{"self":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/599054","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/comments?post=599054"}],"version-history":[{"count":163,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/599054\/revisions"}],"predecessor-version":[{"id":4421945,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/posts\/599054\/revisions\/4421945"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media\/2336031"}],"wp:attachment":[{"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/media?parent=599054"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/categories?post=599054"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/myendoconsult.com\/learn\/wp-json\/wp\/v2\/tags?post=599054"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}