{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T18:21:26Z","timestamp":1790878886850,"version":"4.1.0"},"reference-count":22,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2010,1,1]],"date-time":"2010-01-01T00:00:00Z","timestamp":1262304000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2010,1,1]],"date-time":"2010-01-01T00:00:00Z","timestamp":1262304000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Blood Purif"],"published-print":{"date-parts":[[2010]]},"abstract":"Calcium mass balance (Ca<sub>MB<\/sub>) is determined by the difference between Ca absorbed between dialyses (Ca<sub>Abs<\/sub>) and the Ca removed during dialysis (J<sub>d<\/sub>Ca<sup>2+<\/sup>). A mathematical model to quantify (1) Ca<sub>Abs<\/sub> as a function of Ca intake (Ca<sub>INT<\/sub>) and the doses of vitamin D analogues, and (2) J<sub>d<\/sub>Ca<sup>2+<\/sup> as a function of Ca<sup>2+<\/sup> dialysance, the mean plasma Ca<sup>2+<\/sup> (<sub>M<\/sub>C<sub>pi<\/sub>Ca<sup>2+<\/sup>) minus dialysate Ca<sup>2+<\/sup> (C<sub>di<\/sub>Ca<sup>2+<\/sup>), ultrafiltration rate (Q<sub>f<\/sub>) and treatment time is developed in this paper. The model revealed a basic design flaw in clinical studies of Ca-based as opposed to non-Ca-based binders in that C<sub>di<\/sub>Ca<sup>2+<\/sup> must be reduced with the Ca-based binders in order to avoid a positive Ca<sub>MB<\/sub> relative to the non-Ca-based binders. The model was also used to analyze Ca<sub>MB<\/sub> in 320 Renal Research Institute hemodialysis patients and showed that all patients irrespective of type of binder were in positive Ca<sub>MB<\/sub> between dialyses (mean \u00b1 SD 160 \u00b1 67 mg\/day) with current doses of vitamin D analogues prescribed. Calculation of the optimal C<sub>di<\/sub>Ca<sup>2+<\/sup> for the 320 Renal Research Institute patients revealed that in virtually all instances, the C<sub>di<\/sub>Ca<sup>2+<\/sup> required for neutral Ca<sub>MB<\/sub>, where Ca removal during dialysis was equal to Ca accumulation between dialyses, was less than 2.50 mEq\/l and averaged about 2.00 mEq\/l. This sharply contradicts the recent KDIGO (Kidney Disease: Improving Global Outcomes) Clinical Practice Guideline for the Diagnosis, Evaluation, Prevention, and Treatment of Chronic Kidney Disease \u2013 Mineral and Bone Disorder, that suggests a C<sub>di<\/sub>Ca<sup>2+<\/sup> of 2.5\u20133.0 mEq\/l. Review of the KDIGO work group discussions shows that this discrepancy stems from the unwarranted work group assumption that intradialytic Ca<sub>MB<\/sub> is zero. We strongly believe that this guideline for dialysate Ca<sup>2+<\/sup> is inappropriate and should be modified to more realistically reflect the needs of dialysis patients.<\/jats:p>","DOI":"10.1159\/000245924","type":"journal-article","created":{"date-parts":[[2010,1,8]],"date-time":"2010-01-08T07:10:42Z","timestamp":1262934642000},"page":"163-176","source":"Crossref","is-referenced-by-count":40,"title":["Calcium Balance in Dialysis Is Best Managed by Adjusting Dialysate Calcium Guided by Kinetic Modeling of the Interrelationship between Calcium Intake, Dose of Vitamin D Analogues and the Dialysate Calcium Concentration"],"prefix":"10.1159","volume":"29","author":[{"given":"Frank","family":"Gotch","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan W.","family":"Levin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Kotanko","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2010,1,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1097%2F01.ASN.0000133041.27682.A2"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1523-1755.2005.00421.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1056%2FNEJM200005183422003"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1053%2Fj.ajkd.2003.12.005"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1038%2Fki.1993.92"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1525-139X.2007.00368.x"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1542-4758.2006.00125.x"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1053%2Fj.jrn.2005.10.006"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1159%2F000130679"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1525-139X.2008.00484.x"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1159%2F000096891"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1093%2Fndt%2Fgfp360"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1056%2FNEJM198904273201703"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1172%2FJCI113886"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1172%2FJCI113283"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1097%2F00005792-197311000-00005"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1093%2Fndt%2Fgfn151"},{"key":"ref18","doi-asserted-by":"publisher","DOI":"10.1016%2FS0272-6386%2897%2990330-9"},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.1093%2Fndt%2F17.5.829"},{"key":"ref20","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1523-1755.2002.kid573.x"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1046%2Fj.1525-139X.2003.16102.x"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1053%2Fajkd.1998.v32.pm9669433"}],"container-title":["Blood Purification"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/245924","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/245924","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T17:40:14Z","timestamp":1745430014000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000245924"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010]]},"references-count":22,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2010,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000245924","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.2891958.2560056","asserted-by":"object"}]},"ISSN":["0253-5068","1421-9735"],"issn-type":[{"value":"0253-5068","type":"print"},{"value":"1421-9735","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010]]}}}