{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T22:09:48Z","timestamp":1761862188259,"version":"3.40.4"},"reference-count":2,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2002,1,1]],"date-time":"2002-01-01T00:00:00Z","timestamp":1009843200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2002,1,1]],"date-time":"2002-01-01T00:00:00Z","timestamp":1009843200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nephron"],"published-print":{"date-parts":[[2002]]},"abstract":"The low calcium (Ca<sup>2+<\/sup>) dialysate have been developed to diminish the risk of hypercalcemia with the administration of active vitamin D and Ca<sup>2+<\/sup> carbonate as phosphate binder. Today, increasing numbers of hemodialysis (HD) patients have been on the low Ca<sup>2+<\/sup> dialysate (Ca<sup>2+<\/sup> = 2.5 mEq\/l). However, the clinical consequences of a negative calcium net-balance which may be induced by the use of low Ca dialysate are not well evaluated. In the present study, we explored the effects of low Ca<sup>2+<\/sup> dialysate on the calcium balance and the PTH secretion. Eighty one chronic HD patients (male\/female: 47\/34; mean age: 60.2 \u00b1 1.5 years; mean HD periods: 11.1 \u00b1 0.8 years) who had been dialyzed with 3.0 mEq\/l Ca<sup>2+<\/sup> dialysate were studied. All patients were transferred to the low Ca dialysate, which actually brought about a negative net-balance in Ca (mean: \u201394.5 mg) and an increase in serum intact PTH levels (mean: +23.7%: p = 0.03) during a single HD session. However, no changes in serum ionized Ca<sup>2+<\/sup> were found in spite of negative Ca<sup>2+<\/sup> balance. One month after change to the low Ca<sup>2+<\/sup> dialysate (total 12 sessions in each case), serum intact PTH levels increased significantly (186.7 \u00b1 19.5 vs. 216.2 \u00b1 21.9 pg\/ml: p = 0.01) in spite of the fact that no changes were found in serum ionized Ca<sup>2+<\/sup>, Pi and Mg. This result indicates that the negative Ca<sup>2+<\/sup> balance during low-Ca<sup>2+<\/sup> hemodialysis-stimulated PTH secretion, which offset the decrease of serum Ca<sup>2+<\/sup>; a trade-off phenomenon between negative Ca balance and PTH. This suggests that low Ca<sup>2+<\/sup> dialysate may exaggerate the progression of secondary hyperparathyroidism.<\/jats:p>","DOI":"10.1159\/000064484","type":"journal-article","created":{"date-parts":[[2003,4,15]],"date-time":"2003-04-15T12:11:24Z","timestamp":1050408684000},"page":"86-90","source":"Crossref","is-referenced-by-count":16,"title":["The Negative Ca<sup>2+<\/sup> Balance Is Involved in the Stimulation of PTH Secretion"],"prefix":"10.1159","volume":"92","author":[{"given":"Keitaro","family":"Yokoyama","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shino","family":"Kagami","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ichiro","family":"Ohkido","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naohiko","family":"Kato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyasu","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Shigematsu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaaki","family":"Nakayama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masafumi","family":"Fukagawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshindo","family":"Kawaguchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuo","family":"Hosoya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2002,8,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200005183422003"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1159\/000046092"}],"container-title":["Nephron"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/64484","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/64484","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T04:20:30Z","timestamp":1745468430000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000064484"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2002]]},"references-count":2,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2002,9,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000064484","archive":["Portico"],"relation":{},"ISSN":["1660-8151","2235-3186"],"issn-type":[{"type":"print","value":"1660-8151"},{"type":"electronic","value":"2235-3186"}],"subject":[],"published":{"date-parts":[[2002]]}}}