Calcium/Creatinine Clearance Ratio (FHH vs PHPT)
Calcium/creatinine clearance ratio (CCCR): (urine Ca × serum Cr) / (serum Ca × urine Cr); a ratio < 0.01 suggests familial hypocalciuric hypercalcemia versus primary hyperparathyroidism.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- Urine calcium
- 6
- Serum calcium
- 10
- Serum creatinine
- 1.0
- Urine creatinine
- 100
Result: CCCR 0.006 — suggests familial hypocalciuric hypercalcemia (FHH, < 0.01)
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Bands
- < 0.01 suggests FHH (benign — do not send to parathyroidectomy); > 0.02 suggests primary hyperparathyroidism; 0.01–0.02 indeterminate. Interpret with PTH and family history, never alone.
What you enter
- Urine calcium (shared mass unit)
- Serum calcium (shared mass unit)
- Serum creatinine (shared unit)
- Urine creatinine (shared unit)
How this is calculated
- Formula
- CCCR = (urine Ca × serum Cr) / (serum Ca × urine Cr), dimensionless when the calcium terms share a unit and the creatinine terms share a unit.
Christensen SE, Nissen PH, Vestergaard P, Heickendorff L, Brixen K, Mosekilde L. Discriminative power of three indices of renal calcium excretion for the distinction between familial hypocalciuric hypercalcaemia and primary hyperparathyroidism. Clin Endocrinol (Oxf). 2008;69(5):713-720. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.