{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:20:55Z","timestamp":1790878855221,"version":"4.1.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:00:00Z","timestamp":1585612800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T00:00:00Z","timestamp":1585612800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Kyowa Kirin"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Clin Exp Nephrol"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n<jats:title>Introduction<\/jats:title>\n<jats:p>There is limited evidence about the association between calcium and phosphate levels and mortality stratified by intact parathyroid hormone (iPTH) level.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>We investigated whether differences in iPTH level affect the relationship between calcium and phosphate levels and all-cause mortality in hemodialysis patients with secondary hyperparathyroidism (SHPT). Calcium and phosphate levels were categorized as low (&lt;\u20098.5\u00a0mg\/dL,\u2009&lt;\u20094.0\u00a0mg\/dL), medium (\u2265\u20098.5\u2013&lt;\u20099.5\u00a0mg\/dL,\u2009\u2265\u20094.0\u2013&lt;\u20097.0\u00a0mg\/dL), and high (\u2265\u20099.5\u00a0mg\/dL,\u2009\u2265\u20097.0\u00a0mg\/dL), respectively. iPTH levels were grouped into\u2009&lt;\u2009300 or\u2009\u2265\u2009300\u00a0pg\/mL. Adjusted incidence rate ratios (aIRRs) were analyzed by weighted Poisson regression.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>For calcium, patients with higher iPTH (\u2265\u2009300\u00a0pg\/mL) had significantly higher all-cause mortality rates in the high than in the medium category (aIRR 1.99, 95% confidence interval [CI] 1.16\u20133.42), and tended to have a higher mortality rate in the low category (aIRR 2.04, 95% CI 0.94\u20134.42). Patients with lower iPTH (&lt;\u2009300\u00a0pg\/mL) had higher mortality rates in the high than in the medium category (aIRR 1.65, 95% CI 1.39\u20131.96). For phosphate, the mortality rate was significantly higher in the high than in the medium category in patients with higher and lower iPTH (aIRR 3.23, 95% CI 1.63\u20136.39 for iPTH\u2009\u2265\u2009300\u00a0pg\/mL; aIRR 1.58, 95% CI 1.06\u20132.36 for iPTH\u2009&lt;\u2009300\u00a0pg\/mL).<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusion<\/jats:title>\n<jats:p>High calcium and phosphate levels were associated with increased risk of mortality irrespective of iPTH level.<\/jats:p>\n<\/jats:sec>","DOI":"10.1007\/s10157-020-01879-8","type":"journal-article","created":{"date-parts":[[2020,3,31]],"date-time":"2020-03-31T16:03:47Z","timestamp":1585670627000},"page":"630-637","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Relationship between serum calcium or phosphate levels and mortality stratified by parathyroid hormone level: an analysis from the MBD-5D study"],"prefix":"10.1007","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7717-8945","authenticated-orcid":false,"given":"Shinji","family":"Asada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keitaro","family":"Yokoyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chisato","family":"Miyakoshi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Fukuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichi","family":"Endo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michihito","family":"Wada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanobu","family":"Nomura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Onishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masafumi","family":"Fukagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shunichi","family":"Fukuhara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadao","family":"Akizawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,3,31]]},"reference":[{"key":"1879_CR1","doi-asserted-by":"publisher","first-page":"1945","DOI":"10.1038\/sj.ki.5000414","volume":"69","author":"S Moe","year":"2006","unstructured":"Moe S, Dr\u00fceke T, Cunningham J, Goodman W, Martin K, Olgaard K, et al. 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(KKC). KY has received consulting fees from Torii Pharmaceutical, and lecture fees from KKC, Torii Pharmaceutical, and Ono Pharmaceutical. CM and YO do not have any conflicts of interest to declare. S. Fukuma has acted as a scientific advisor for KKC. MF has received consulting fees from KKC and Ono Pharmaceutical; lecture fees from KKC, Bayer, Torii Pharmaceutical, and Ono Pharmaceutical; and grants from KKC and Bayer. S. Fukuhara has acted as a scientific advisor for and has received grants from KKC. TA has received consulting fees from KKC, Astellas Pharma, Bayer, Fuso Pharmaceutical, Japan Tobacco, Ono Pharmaceutical, Sanwa Chemical, Otsuka, GSK and NIPRO, and lecture fees from KKC, Chugai Pharmaceutical, Bayer, Kissei Pharmaceutical, Torii Pharmaceutical, and Ono Pharmaceutical.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The study protocol was approved by the central ethics committee at Kobe University's School of Medicine (No. 754).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Informed consent was not mandatory according to the ethical guidelines for epidemiological research in Japan. The study is registered at ClinicalTrials.gov (NCT00995163).","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}