2. Glycosuria
The presence of sugar or glucose in the
urine
– Two basic causes:
Blood glucose levels are so elevated that the renal
tubules are unable to reabsorb all that is present
Failure of tubules to reabsorb when glucose levels
are normal
– Renal glycosuria
3.
4. Blood Glucose Levels
Under normal circumstances about 10 mmol/L
It can occur in the non-diabetic if a substantial amount
of food high in sugar is consumed and transiently
overwhelms the insulin response causing hyperglycemia
Some hyperglycemia causes
– Thyrotoxicosis
– Acromegaly
– Severe anxiety
– Diabetes mellitus
– Cushing’s disease
– Pancreas dysfunction
Glycosuria occurs when a normal renal threshold has
been exceeded due to hyperglycemia
5. Renal Glycosuria
In pregnancy
– Results from increased renal blood flow
– Tubules are presented with a greater volume
each minute
– May be the first sign of gestational diabetes
6. Renal Glycosuria
Other causes
– Fanconi’s Syndrome
Inadequate proximal renal tubular reabsorption of
glucose
Inherited or acquired
Other symptoms include
– growth failure, rickets, polyuria, polydipsia, or
dehydration
7. Renal Glysuria
Some secondary causes:
– Oculocerebrorenal dystrophy (Lowe's syndrome)
– Cystinosis
– Wilson's disease
– Interstitial nephritis
– Hereditary tyrosinemia
– Heavy metal poisoning such as lead, mercury or after
use of out-of-date tetracycline
– Intestinal glucose-galactose malabsorption (where
the defective sodium-dependent glucose co-
transporter protein is also present in the renal
tubules)
8. Benign Glycosuria
Occurs without significant pathology
Divided into 3 categories
– Type A
Classical glycosuria, with reduction in both glucose threshold
and maximal glucose reabsorption rate
– In type B
Reduction in the glucose threshold and a normal rate of
reabsorption
– Type O
Failure of glucose reabsorption
Plasma glucose, glucose tolerance test (GTT), insulin levels
and HbA1C are all normal
9. Hypercalcemia
Condition of excessive calcium levels in the
blood
– Normal range: 9-10.5 mg/dL or 2.2-2.6 mmol/L
– Symptoms are more common at high calcium blood
values
12.0 mg/dL or 3 mmol/l).
– Severe hypercalcemia
above 15-16 mg/dL or 3.75-4 mmol/l
considered a medical emergency
– coma and cardiac arrest can result
10.
11.
12. Signs and Symptoms
Some signs of Chronic
hypercalcemia hypercalcemia
– fatigue – Urinary calculi (renal
– depression stones or bladder
– stones)
confusion
– Abnormal heart
– anorexia
rhythms ECG findings
– nausea of a short QT interval
– vomiting and a widened T wave
– constipation
– pancreatitis Peptic ulcers may also
– polyuria occur
13. Remember: "groans (constipation), moans (psychotic
noise), bones (bone pain, especially if PTH is elevated),
and stones (kidney stones)”
14. – Excessive skeletal – Hyperparathyroidism
calcium release and malignancy
– Increased intestinal account for about 90%
calcium absorption of hypercalcemia
– Decreased renal – Other causes
calcium excretion Cancer
Disorders related to
– Indicative of another
bone loss
disease
Medications
Excessive use of
calcium and vitamin D
supplements
17. resources cited
aafp.org
Fremgen, Bonnie F. & Frucht, Suzanne S.
Medical Terminology: A Living Language:
3e. New Jersey: Pearson Education. 2005
patient.co.uk
wikipedia.org
