{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T21:10:44Z","timestamp":1790802644256,"version":"4.1.0"},"reference-count":18,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,6,20]],"date-time":"2018-06-20T00:00:00Z","timestamp":1529452800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ther Apher Dial"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Although the Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend a dialysate calcium concentration between 2.5 and 3.0\u2009mEq\/L, its optimal concentration remains unclear. A total of 53 hemodialysis patients with intact parathyroid hormone (PTH) levels &lt;150\u2009pg\/mL were enrolled in this prospective observational study. A dialysate calcium concentration was converted from 3.0 to 2.75\u2009mEq\/L and bone metabolic markers including bone alkaline phosphatase (BAP) and tartrate\u2010resistant acid phosphatase\u20105b (TRACP\u20105b) were examined. After 3\u2009months, serum corrected calcium levels decreased (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001), while serum intact PTH, BAP and TRACP\u20105b levels increased (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05 and <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001, respectively). Multiple regression analyses showed that the amount of change in BAP was significantly associated with dialysis vintage (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.01). In conclusion, the lowering of dialysate calcium concentration stimulated parathyroid gland and bone remodeling in hemodialysis patients with suppressed PTH, particularly with longer dialysis vintage.<\/jats:p>","DOI":"10.1111\/1744-9987.12673","type":"journal-article","created":{"date-parts":[[2018,6,20]],"date-time":"2018-06-20T11:45:51Z","timestamp":1529495151000},"page":"503-508","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Effects of Lowering Dialysate Calcium Concentration on Bone Metabolic Markers in Hemodialysis Patients With Suppressed Serum Parathyroid Hormone: A Preliminary Study"],"prefix":"10.1111","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1927-6448","authenticated-orcid":false,"given":"Hiroki","family":"Niwa","sequence":"first","affiliation":[{"name":"Renal Division, Department of Internal Medicine Iwata City Hospital  Iwata 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