{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T17:08:43Z","timestamp":1788541723251,"version":"build-2803163510"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T00:00:00Z","timestamp":1770076800000},"content-version":"vor","delay-in-days":1313,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003551","name":"Royal Canin","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003551","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003551","name":"Royal Canin","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003551","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Hypercalcemia is associated with chronic kidney disease (CKD) in cats, but studies assessing the physiologically relevant ionized calcium fraction are lacking.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To describe the prevalence and incidence rate of ionized hypercalcemia, and to explore predictor variables to identify cats at risk of ionized hypercalcemia in a cohort of cats diagnosed with azotemic CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Animals<\/jats:title>\n                    <jats:p>One hundred sixty-four client-owned cats with azotemic CKD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Variables independently associated with ionized hypercalcemia at diagnosis of azotemic CKD were explored by binary logistic regression. Cats that were normocalcemic at diagnosis of azotemic CKD were followed over a 12-month period or until ionized hypercalcemia occurred and baseline predictor variables for ionized hypercalcemia explored using Cox proportional hazards and receiver operating characteristic curve analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ionized hypercalcemia (median, 1.41\u2009mmol\/L; range, 1.38-1.68) was observed in 33\/164 (20%) cats at diagnosis of azotemic CKD and was associated with male sex, higher plasma total calcium and potassium concentrations, and lower plasma parathyroid hormone concentrations. Twenty-five of 96 initially normocalcemic (26%) cats followed for minimum 90\u2009days developed ionized hypercalcemia (median, 1.46\u2009mmol\/L; range, 1.38-1.80) at a median of 140\u2009days after diagnosis of azotemic CKD (incidence rate, 0.48 per feline patient-year). Only body condition score was independently associated with incident ionized hypercalcemia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Clinical Importance<\/jats:title>\n                    <jats:p>The occurrence of ionized hypercalcemia is high in cats with CKD. Continued monitoring of blood ionized calcium concentrations is advised.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jvim.16430","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T06:41:38Z","timestamp":1653374498000},"page":"1312-1321","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Ionized hypercalcemia in cats with azotemic chronic kidney disease (2012-2018)"],"prefix":"10.1093","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1231-7799","authenticated-orcid":false,"given":"Dirk Hendrik Nicolaas","family":"van den Broek","sequence":"first","affiliation":[{"name":"Royal Veterinary College, University of London Department of Clinical Science and Services, , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9216-4886","authenticated-orcid":false,"given":"Rebecca F.","family":"Geddes","sequence":"additional","affiliation":[{"name":"Royal Veterinary College, University of London Department of Clinical Science and Services, , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola S.","family":"L\u00f6tter","sequence":"additional","affiliation":[{"name":"Royal Veterinary College, University of London Department of Comparative Biomedical Science, , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu-Mei","family":"Chang","sequence":"additional","affiliation":[{"name":"Research Support Office, Royal Veterinary College, University of London , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Elliott","sequence":"additional","affiliation":[{"name":"Royal Veterinary College, University of London Department of Comparative Biomedical Science, , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanne E.","family":"Jepson","sequence":"additional","affiliation":[{"name":"Royal Veterinary College, University of London Department of Clinical Science and Services, , London,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,7,1]]},"reference":[{"issue":"4","key":"2026020304001720500_jvim16430-bib-0001","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1111\/jvim.14643","article-title":"Chronic kidney disease in cats and the risk of total hypercalcemia","volume":"31","author":"van den Broek","year":"2017","journal-title":"J Vet Intern Med"},{"issue":"4","key":"2026020304001720500_jvim16430-bib-0002","first-page":"209","article-title":"Prediction of serum ionized calcium concentration by serum total calcium measurement in cats","volume":"74","author":"Schenck","year":"2010","journal-title":"Can J Vet Res"},{"issue":"4","key":"2026020304001720500_jvim16430-bib-0003","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1111\/j.1748-5827.1998.tb03613.x","article-title":"Feline chronic renal failure: calcium homeostasis in 80 cases diagnosed between 1992 and 1995","volume":"39","author":"Barber","year":"1998","journal-title":"J Small Anim Pract"},{"issue":"4","key":"2026020304001720500_jvim16430-bib-0004","doi-asserted-by":"crossref","first-page":"23","DOI":"10.2215\/CJN.05910809","article-title":"Calcium metabolism in health and disease","volume":"5","author":"Peacock","year":"2010","journal-title":"Clin J Am Soc Nephrol"},{"issue":"4","key":"2026020304001720500_jvim16430-bib-0005","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1038\/ki.1983.46","article-title":"Mechanism of concentrating defect in hypercalcemia. 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