{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T03:20:47Z","timestamp":1762917647633},"reference-count":34,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,10,20]],"date-time":"2015-10-20T00:00:00Z","timestamp":1445299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ther Apher Dial"],"published-print":{"date-parts":[[2016,2]]},"abstract":"Abstract<\/jats:title>Selection of a lower dialysate calcium concentration (DCa<\/jats:styled-content>) can reduce calcium burden and prevent vascular calcification in hemodialysis patients. However, decreased DCa<\/jats:styled-content> can worsen mineral and bone disorders. This 1\u2010year retrospective observational study evaluated 121 hemodialysis patients at F<\/jats:styled-content>ukuoka R<\/jats:styled-content>enal C<\/jats:styled-content>linic who underwent conversion of DCa<\/jats:styled-content> from 3.0\u2009mEq\/L to 2.75\u2009mEq\/L. The primary outcomes were changes in serum levels of calcium, phosphate, and parathyroid hormone (PTH<\/jats:styled-content>). The effects of baseline serum calcium and PTH<\/jats:styled-content> levels on changes in biochemical parameters were also determined. One year after DCa<\/jats:styled-content> conversion, mean serum calcium level decreased, while serum phosphate, alkaline phosphatase, and PTH<\/jats:styled-content> concentrations increased. The rate of achievement of target PTH<\/jats:styled-content> was higher in patients with lower serum PTH<\/jats:styled-content> level at baseline, while patients with higher baseline serum PTH<\/jats:styled-content> level tended to exceed the upper limit of the PTH<\/jats:styled-content> target range. Patients with higher baseline serum calcium concentration showed a greater decrease in serum calcium level and a greater increase in serum PTH<\/jats:styled-content> level at 1 year. Patients with a lower baseline serum PTH<\/jats:styled-content> level can benefit from optimal PTH<\/jats:styled-content> control following conversion of DCa<\/jats:styled-content> from 3.0\u2009mEq\/L to 2.75\u2009mEq\/L. However, secondary hyperparathyroidism may be exacerbated in some patients with higher baseline serum calcium (Ca) and PTH<\/jats:styled-content> levels. These results indicate that an individualized approach can maximize the benefits of C<\/jats:styled-content>a unloading after conversion to lower DCa<\/jats:styled-content>.<\/jats:p>","DOI":"10.1111\/1744-9987.12329","type":"journal-article","created":{"date-parts":[[2015,10,20]],"date-time":"2015-10-20T13:18:47Z","timestamp":1445347127000},"page":"31-39","source":"Crossref","is-referenced-by-count":10,"title":["Effects of Lowering Dialysate Calcium Concentration on Mineral and Bone Disorders in Chronic Hemodialysis Patients: Conversion from 3.0\u2009mEq\/L<\/scp> to 2.75\u2009mEq\/L<\/scp>"],"prefix":"10.1111","volume":"20","author":[{"given":"Shunsuke","family":"Yamada","sequence":"first","affiliation":[{"name":"Department of Medicine and Clinical Science Graduate School of Medical Sciences, Kyushu University Fukuoka Japan"},{"name":"Department of Internal Medicine Fukuoka Dental College Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Ueki","sequence":"additional","affiliation":[{"name":"Department of Medicine and Clinical Science Graduate School of Medical Sciences, Kyushu University Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Tokumoto","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Fukuoka Dental College Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaichi","family":"Suehiro","sequence":"additional","affiliation":[{"name":"Department of Medicine and Clinical Science Graduate School of Medical Sciences, Kyushu University Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Kimura","sequence":"additional","affiliation":[{"name":"Department of Medicine and Clinical Science Graduate School of Medical Sciences, Kyushu University Fukuoka Japan"},{"name":"Fukuoka Renal Clinic Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masatomo","family":"Taniguchi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Clinical Science Graduate School of Medical Sciences, Kyushu University Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoru","family":"Fujimi","sequence":"additional","affiliation":[{"name":"Fukuoka Renal Clinic Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanari","family":"Kitazono","sequence":"additional","affiliation":[{"name":"Department of Medicine and Clinical Science Graduate School of Medical Sciences, Kyushu University Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhiko","family":"Tsuruya","sequence":"additional","affiliation":[{"name":"Department of Medicine and Clinical Science Graduate School of Medical Sciences, Kyushu University Fukuoka Japan"},{"name":"Department of Integrated Therapy for Chronic Kidney Disease Graduate School of Medical Sciences, Kyushu University Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,10,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000133041.27682.A2"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.ki.5001542"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2005.00421.x"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000129337.50739.48"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2011.08.033"},{"key":"e_1_2_7_7_1","first-page":"S1","article-title":"KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease\u2010Mineral and Bone Disorder (CKD\u2010MBD). 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