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🧪 Calcium-Creatinine Ratio (Spot Urine Test)

Parameter	Details
Sample Type	Spot urine sample
Fasting Required	🚫 Not mandatory (but early morning fasting sample is preferred)
Organs Involved	Kidneys, Parathyroid gland, Bones
Main Use	Evaluate urinary calcium excretion, rule out hypercalciuria or calcium metabolism disorders

🔍 What is the Calcium/Creatinine Ratio?

This test calculates the amount of calcium excreted in urine relative to creatinine, to assess:

📈 Normal Reference Range

Age Group	Calcium/Creatinine Ratio (mg/mg)
Adults	< 0.20 mg/mg
Children (<2 years)	Can be up to 0.6–0.7 mg/mg
Infants & Toddlers	Higher values are physiologically normal

Interpretation depends on age, diet, and clinical symptoms.

🔺 High Calcium/Creatinine Ratio Indicates:

Possible Cause	Explanation
Hypercalciuria	Excess calcium in urine
Hyperparathyroidism	Overactive parathyroid glands
Excess vitamin D or calcium intake	Supplements or over-fortified foods
Kidney stones	Especially calcium oxalate type
Renal tubular acidosis (RTA)	Tubular dysfunction affecting calcium handling

🔻 Low Ratio Is Less Common, but may be due to:

🧪 Tests Commonly Done Along With Calcium/Creatinine Ratio

Test	Why
Serum Calcium	Core calcium status
Vitamin D (25 OH)	Assesses calcium absorption regulation
Parathyroid Hormone (PTH)	Direct calcium regulator from parathyroid gland
Serum Creatinine / eGFR	Renal function assessment
Serum Phosphorus & Magnesium	Balance and influence calcium homeostasis
Urine pH	Assesses stone formation risk

📋 Summary

Test	Calcium/Creatinine Ratio (Spot Urine)
Sample	Spot urine sample
Fasting Needed	Not strictly, but early morning preferred
Normal Range (Adults)	< 0.20 mg/mg
High Levels Indicate	Hypercalciuria, hyperparathyroidism, kidney stone risk
Paired With	Serum calcium, vitamin D, PTH, serum creatinine

Calcium creatinine ratio (Spot)