Above is a Flash movie about hypercalciuria. You need the Flash player, which is a free download. If you have a small screen, you will need a screen resolution of 96 dpi, or the window will not fit. Click on "pathophysiology" on the main menu to begin. When you finish that section, return to the menu page and click on "osteopenia". Be sure to try all the nephron segments to see the movies!

Here is a differential diagnosis of hypercalciuria and outline of flash presentation:

I. Pathophysiology
Filtered load
     Increased calcium load
          bone resorption
          intestinal absorption
               dietary intake, vitamin D excess, phosphate wasting
               review renal phosphate  transport and rickets
     Increased glomerular filtration
          amino acids, caffeine, pregnancy
Proximal tubular reabsorption
     sodium excess
     acidosis 
     mannitol
     Dent's disease
Reabsorption from the loop
     loop diuretics
     activating mutations of CaSR
     mutations in claudin-16
Distal tubular reabsorption
     hypoparathyroidism
     acidosis
     low vitamin D
     pseudohypoaldosteronism II
     [thiazide, amiloride, Gitelman's disease cause hypocalciuria]
Collecting duct
     CaSR inhibits ADH

II. Hypercalciuria and relationship to bone density
III. Thiazides and bone disease

If you want to use the flash movies for teaching, please email me for downloading directions.