{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T04:27:21Z","timestamp":1785472041286,"version":"3.56.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T00:00:00Z","timestamp":1701302400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypercalcemia is highly\u00a0prevalent in kidney transplant recipients with hyperparathyroidism. However, its long-term impact on graft function is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective cohort study investigating adverse graft outcomes associated with persistent hypercalcemia (free calcium\u2009&amp;gt;\u20095.2\u00a0mg\/dL in \u2265\u200980% of measures) and inappropriately elevated intact parathyroid hormone (&amp;gt;\u200930\u00a0pg\/mL) in kidney transplant recipients. Asymptomatic mild hypercalcemia was monitored unless complications developed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We included 385 kidney transplant recipients. During a 4-year (range 1\u20139) median follow-up\u00a0time, 62% of kidney transplant recipients presented persistent hypercalcemia. Compared to kidney transplant recipients without hypercalcemia, there were no significant differences in graft dysfunction (10% vs. 12%, p\u2009=\u20090.61), symptomatic urolithiasis (5% vs. 3%, p\u2009=\u20090.43), biopsy-proven calcium deposits (6% vs. 5%, p\u2009=\u20091.0), fractures (6% vs. 4%, p\u2009=\u20090.64), and a composite outcome of urolithiasis, calcium deposits, fractures, and parathyroidectomy indication (16% vs. 13%, p\u2009=\u20090.55). In a subset of 76 kidney transplant recipients, subjects with persistent hypercalcemia had higher urinary calcium (median 84 [43\u2013170] vs. 38 [24\u201364]\u00a0mg\/day, p\u2009=\u20090.03) and intact fibroblast growth factor 23 (median 36 [24\u201354] vs. 27 [19\u201340]\u00a0pg\/mL, p\u2009=\u20090.04), and lower 25-hydroxyvitamin D levels (11.3\u2009\u00b1\u20091.2 vs. 16.3\u2009\u00b1\u20091.4\u00a0ng\/mL, p\u2009&amp;lt;\u20090.001). In multivariate analysis, pretransplant intact parathyroid hormone &amp;lt;\u2009300\u00a0pg\/mL was associated with a reduced risk of post-transplant hypercalcemia (OR 0.51, 95% CI 0.32\u20130.80).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Long-term persistent mild hypercalcemia (tertiary hyperparathyroidism) was frequent in kidney transplant recipients\u00a0in our series. This condition presented with lower phosphate and 25-hydroxyvitamin D, and higher urinary calcium and intact fibroblast growth factor 23 levels compared to kidney transplant recipients without hypercalcemia, resembling a mild form of primary hyperparathyroidism. Despite these metabolic derangements, the risk of adverse graft outcomes was low.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Graphical abstract<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1007\/s40620-023-01815-5","type":"journal-article","created":{"date-parts":[[2023,11,30]],"date-time":"2023-11-30T05:02:22Z","timestamp":1701320542000},"page":"1497-1507","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Long-term effects of hypercalcemia in kidney transplant recipients with persistent hyperparathyroidism"],"prefix":"10.1093","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2735-2941","authenticated-orcid":false,"given":"Juan Carlos","family":"Ramirez-Sandoval","sequence":"first","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lluvia","family":"Marino","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Cojuc-Konigsberg","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estefania","family":"Reul-Linares","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie Desire","family":"Pichardo-Cabrera","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristino","family":"Cruz","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elisa Naomi","family":"Hern\u00e1ndez-Paredes","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Berman-Parks","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Vidal-Ru\u00edz","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan Mauricio","family":"Estrada-Linares","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfredo Adolfo","family":"Reza-Albarr\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Mexico City, Mexico 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Correa-Rotter","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Eduardo","family":"Morales-Buenrostro","sequence":"additional","affiliation":[{"name":"Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias M\u00e9dicas y Nutrici\u00f3n Salvador Zubir\u00e1n, Vasco de Quiroga 15, colonia Secci\u00f3n XVI, 14080, Mexico City, CDMX, Mexico 1"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"key":"2026012110482599600_CR1","first-page":"190","article-title":"The fate of bone after renal transplantation","volume":"7","author":"Brandenburg","year":"2004","journal-title":"J Nephrol"},{"key":"2026012110482599600_CR2","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1093\/oxfordjournals.ndt.a027843 9509459","article-title":"Sequential changes of biochemical bone parameters after kidney transplantation","volume":"13","author":"Reinhardt","year":"1998","journal-title":"Nephrol Dial Transplant"},{"key":"2026012110482599600_CR3","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1016\/j.ecl.2021.08.004","article-title":"Tertiary, and postrenal transplantation hyperparathyroidism","volume":"50","author":"Alfieri","year":"2021","journal-title":"Endocrinol Metab Clin N Am"},{"key":"2026012110482599600_CR4","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1093\/ndt\/gfh128 14993493","article-title":"Natural history of parathyroid function and calcium metabolism after kidney transplantation: a single-centre study","volume":"19","author":"Evenepoel","year":"2004","journal-title":"Nephrol Dial Transplant"},{"key":"2026012110482599600_CR5","doi-asserted-by":"publisher","first-page":"184","DOI":"10.1097\/TP.0000000000000823 26177089","article-title":"A prospective cohort study of mineral metabolism after kidney transplantation","volume":"100","author":"Wolf","year":"2016","journal-title":"Transplantation"},{"key":"2026012110482599600_CR6","doi-asserted-by":"publisher","first-page":"351","DOI":"10.1097\/TP.0000000000000583 25594550","article-title":"Increased risk of all-cause mortality and renal graft loss in stable renal transplant recipients with hyperparathyroidism","volume":"99","author":"Pihlstr\u00f8m","year":"2015","journal-title":"Transplantation"},{"key":"2026012110482599600_CR7","doi-asserted-by":"publisher","first-page":"2437","DOI":"10.1111\/ajt.16457 33331113","article-title":"Association of time-updated plasma calcium and phosphate with graft and patient outcomes after kidney transplantation","volume":"21","author":"van der Plas","year":"2021","journal-title":"Am J Transplant"},{"key":"2026012110482599600_CR8","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.bone.2016.08.022 27576942","article-title":"Calcium as a cardiovascular toxin in CKD-MBD","volume":"100","author":"Moe","year":"2017","journal-title":"Bone"},{"key":"2026012110482599600_CR9","doi-asserted-by":"publisher","first-page":"1919","DOI":"10.1007\/s11255-016-1391-z 27522659","article-title":"The effect of hypercalcemia on allograft calcification after kidney transplantation","volume":"48","author":"\u00c7eltik","year":"2016","journal-title":"Int Urol Nephrol"},{"key":"2026012110482599600_CR10","doi-asserted-by":"publisher","first-page":"442","DOI":"10.1080\/00365513.2017.1336568","article-title":"Albumin adjustment of total calcium does not improve the estimation of calcium status","volume":"77","author":"Ridefelt","year":"2017","journal-title":"Scand J Clin Lab Investig"},{"key":"2026012110482599600_CR11","doi-asserted-by":"publisher","first-page":"78","DOI":"10.5301\/jn.2010.293 20437396","article-title":"Hypercalcemia secondary to persistent hyperparathyroidism in kidney transplant patients: analysis after a year with cinacalcet","volume":"24","author":"Guerra","year":"2011","journal-title":"J Nephrol"},{"key":"2026012110482599600_CR12","first-page":"68","article-title":"Renal metabolic bone disease in the potential kidney transplant recipient","volume":"9","author":"Ram\u00edrez-Sandoval","year":"2020","journal-title":"Rev Mex Traspl"},{"key":"2026012110482599600_CR13","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1111\/nep.13854 33502071","article-title":"Clinical factors associated with early and persistent hypocalcaemia after parathyroidectomy in patients on dialysis with severe hyperparathyroidism","volume":"26","author":"Fonseca-Correa","year":"2021","journal-title":"Nephrology (Carlton)"},{"key":"2026012110482599600_CR14","doi-asserted-by":"publisher","first-page":"1737","DOI":"10.1056\/NEJMoa2102953 34554658","article-title":"New creatinine- and cystatin C-based equations to estimate GFR without race","volume":"385","author":"Inker","year":"2021","journal-title":"N Engl J Med"},{"key":"2026012110482599600_CR15","doi-asserted-by":"publisher","first-page":"2293","DOI":"10.1002\/jbmr.4677 36245251","article-title":"International workshop on primary hyperparathyroidism. Evaluation and management of primary hyperparathyroidism: summary statement and guidelines from the fifth international workshop","volume":"37","author":"Bilezikian","year":"2022","journal-title":"J Bone Miner Res"},{"key":"2026012110482599600_CR16","doi-asserted-by":"publisher","first-page":"680","DOI":"10.1001\/jama.2014.9195","article-title":"Parathyroid hormone in the evaluation of hypercalcemia","volume":"312","author":"Cusano","year":"2014","journal-title":"JAMA"},{"key":"2026012110482599600_CR17","doi-asserted-by":"publisher","first-page":"2625","DOI":"10.1007\/s11255-022-03170-z 35294676","article-title":"Validation of an equation for free calcium estimation: accuracy improves after adjustment for phosphate and CO2","volume":"54","author":"Ramirez-Sandoval","year":"2022","journal-title":"Int Urol Nephrol"},{"key":"2026012110482599600_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.kisu.2017.04.001","article-title":"KDIGO 2017 clinical practice guideline update for the diagnosis, evaluation, prevention, and treatment of chronic kidney disease-mineral and bone disorder (CKD-MBD)","volume":"7","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD-MBD Update Work Group","year":"2011","journal-title":"Kidney Int Suppl"},{"issue":"1","key":"2026012110482599600_CR19","doi-asserted-by":"publisher","first-page":"25","DOI":"10.3390\/biomedicines11010025 36672533","article-title":"Systematic review of the treatment of persistent hyperparathyroidism following kidney transplantation","volume":"11","author":"Miedziaszczyk","year":"2022","journal-title":"Biomedicines"},{"key":"2026012110482599600_CR20","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1046\/j.1523-1755.1999.00589.x 10432404","article-title":"Reduced parathyroid functional mass after successful kidney transplantation","volume":"56","author":"Bonarek","year":"1999","journal-title":"Kidney Int"},{"key":"2026012110482599600_CR21","doi-asserted-by":"publisher","first-page":"1788","DOI":"10.1046\/j.1523-1755.2000.00341.x 11012914","article-title":"Cyclosporine bone remodeling effect prevents steroid osteopenia after kidney transplantation","volume":"58","author":"Westeel","year":"2000","journal-title":"Kidney Int"},{"key":"2026012110482599600_CR22","doi-asserted-by":"publisher","first-page":"2576","DOI":"10.3390\/nu14132576 35807756","article-title":"The increase in FGF23 induced by calcium is partially dependent on vitamin D signaling","volume":"14","author":"Rayego-Mateos","year":"2022","journal-title":"Nutrients"},{"key":"2026012110482599600_CR23","doi-asserted-by":"publisher","first-page":"4469","DOI":"10.1210\/en.2013-1627 24140714","article-title":"Calcium regulates FGF-23 expression in bone","volume":"154","author":"David","year":"2013","journal-title":"Endocrinology"},{"key":"2026012110482599600_CR24","doi-asserted-by":"publisher","first-page":"1046","DOI":"10.1038\/ki.2012.273 23128114","article-title":"Enhanced induction of Cyp24a1 by FGF23 but low serum 24,25-dihydroxyvitamin D in CKD: implications for therapy","volume":"82","author":"Dusso","year":"2012","journal-title":"Kidney Int"},{"key":"2026012110482599600_CR25","doi-asserted-by":"publisher","first-page":"2546","DOI":"10.1111\/j.1600-6143.2007.01978.x 17908281","article-title":"Vitamin D status in renal transplant recipients","volume":"7","author":"Stavroulopoulos","year":"2007","journal-title":"Am J Transplant"},{"key":"2026012110482599600_CR26","doi-asserted-by":"publisher","first-page":"2653","DOI":"10.1111\/ajt.12425 24034142","article-title":"Persistent hyperparathyroidism is a major risk factor for fractures in the five years after kidney transplantation","volume":"13","author":"Perrin","year":"2013","journal-title":"Am J Transplant"},{"key":"2026012110482599600_CR27","doi-asserted-by":"publisher","first-page":"677","DOI":"10.1007\/s40618-019-01162-y","article-title":"Hypercalciuria: its value as a predictive risk factor for nephrolithiasis in asymptomatic primary hyperparathyroidism?","volume":"43","author":"Saponaro","year":"2020","journal-title":"J Endocrinol Investig"},{"key":"2026012110482599600_CR28","doi-asserted-by":"publisher","first-page":"465","DOI":"10.1016\/s0889-8529(05)70146-8","article-title":"Primary hyperparathyroidism. When to observe and when to operate","volume":"29","author":"Bilezikian","year":"2000","journal-title":"Endocrinol Metab Clin N Am"},{"key":"2026012110482599600_CR29","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/j.surg.2021.03.067 34266650","article-title":"Prevalence and risk factors for tertiary hyperparathyroidism in kidney transplant recipients","volume":"171","author":"Sutton","year":"2022","journal-title":"Surgery"},{"key":"2026012110482599600_CR30","doi-asserted-by":"publisher","first-page":"S1","DOI":"10.1016\/S0272-6386(03)00905-3","article-title":"K\/DOQI clinical practice guidelines for bone metabolism and disease in chronic kidney disease","volume":"42","author":"National Kidney Foundation","year":"2003","journal-title":"Am J Kidney Dis"},{"key":"2026012110482599600_CR31","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1592\/phco.21.5.405.34503 11310512","article-title":"Post hoc power analysis: an idea whose time has passed?","volume":"21","author":"Levine","year":"2001","journal-title":"Pharmacotherapy"},{"issue":"3","key":"2026012110482599600_CR32","doi-asserted-by":"publisher","first-page":"525","DOI":"10.3803\/EnM.2021.1061 34107603","article-title":"Normocalcemic primary hyperparathyroidism: need for a standardized clinical approach","volume":"36","author":"Zavatta","year":"2021","journal-title":"Endocrinol Metab (Seoul)"},{"key":"2026012110482599600_CR33","doi-asserted-by":"publisher","first-page":"262","DOI":"10.3747\/pdi.2014.00250 26293840","article-title":"Biomarkers associated with vascular calcification in peritoneal dialysis","volume":"36","author":"Ramirez-Sandoval","year":"2016","journal-title":"Perit Dial Int"}],"container-title":["Journal of Nephrology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-023-01815-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s40620-023-01815-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/joneph\/article-pdf\/37\/6\/1497\/66514888\/joneph_37_6_1815.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s40620-023-01815-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/academic.oup.com\/joneph\/article-pdf\/37\/6\/1497\/66514888\/joneph_37_6_1815.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T15:48:33Z","timestamp":1769010513000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/joneph\/article\/37\/6\/1497\/8306811"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,30]]},"references-count":33,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2023,11,30]]},"published-print":{"date-parts":[[2024,7,1]]}},"URL":"https:\/\/doi.org\/10.1007\/s40620-023-01815-5","relation":{},"ISSN":["1121-8428","1724-6059"],"issn-type":[{"value":"1121-8428","type":"print"},{"value":"1724-6059","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,7,1]]},"published":{"date-parts":[[2023,11,30]]},"assertion":[{"value":"4 June 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 November 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The results presented in this paper have not been published previously. The authors of this paper declare that the paper is original, is not plagiarized, is submitted for first publication in this journal, and has not been published or submitted for publication elsewhere, and that there is no affiliation with any organization with a direct or indirect financial interest in the subject matter discussed in the manuscript that may affect the reporting of the article submitted. No pharmaceutical or biotechnology company, foundation, or any other source participated in the design, monitoring, data collection, and analysis. Dr. Juan Carlos Ram\u00edrez-Sandoval is a member of the Review Board of Frontiers in medicine, has received honoraria from Bayer M\u00e9xico, and has lectured for Abbvie, Amgen, Synthom, Bayer, and AstraZeneca. Dr. Ricardo Correa-Rotter is a member of the Review Board of Blood Purification, has received honoraria as consultant from AbbVie, AstraZeneca, GlaxoSmithKline, Bayer, and Boehringer Ingelheim, participates in research from: Boehringer Ingelheim, Baxter, AstraZeneca and has lectured for Amgen, AstraZeneca, Bayer, Boehringer Ingelheim and Sanofi. Luis E. Morales-Buenrostro has received honoraria from AstraZeneca, Boehringer Ingelheim, Sanofi, Asofarma, and Roche. Lluvia Marino Gabriel Cojuc-Konigsberg, Estefania Reul-Linares, Nathalie Desire Pichardo-Cabrera, Cristino Cruz, Elisa Naomi Hern\u00e1ndez-Paredes, Nathan Berman-Parks, Vanesa Vidal Ruiz, Jonathan Mauricio Estrada Linares, and Alfredo A. Reza-Albarr\u00e1n have no competing interest to declare.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was approved by the local Human Research and Ethics Boards (NMM-4220-22-23-1) and adhered to the principles outlined in the 1964 Helsinki Declaration and its subsequent amendments.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"This study does not contain any studies with animals performed by any of the authors.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Human and animal rights"}},{"value":"Participants who underwent biomarker assessment provided informed consent.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}