CASR and nephrocalcinosis: Three main complications have been reported: nephrolithiasis, nephrocalcinosis, and chronic kidney disease (CKD).(115) Because the activation of the CaSR inhibits distal tubular Ca reabsorption and enhances urinary Ca excretion, these problems are especially frequent in patients with autosomal dominant hypocalcemia 1 caused by activating mutations in CASR.