{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:45:55Z","timestamp":1792788355040,"version":"4.5.0"},"reference-count":35,"publisher":"The Endocrine Society","issue":"2","license":[{"start":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T00:00:00Z","timestamp":1752537600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K23DK118197"],"award-info":[{"award-number":["K23DK118197"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["L30DK110882"],"award-info":[{"award-number":["L30DK110882"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01DK101720"],"award-info":[{"award-number":["R01DK101720"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["K24 DK110427"],"award-info":[{"award-number":["K24 DK110427"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007911","name":"University of California San Diego","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007911","id-type":"DOI","asserted-by":"publisher"}]},{"name":"O\u2019Brien Center for Acute Kidney Injury Research"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Therapeutic plasma exchange (TPE) removes plasma proteins and other unwanted substances, causing nonspecific alterations of plasma components. A previous study showed an approximately 70% reduction in vitamin D metabolites following a single TPE treatment, prompting further investigation into TPE's effects on vitamin D regulators and metabolites: calcium, phosphate, parathyroid hormone (PTH), and fibroblast growth factor-23 (FGF-23).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study examined changes in plasma and effluent levels of total calcium, phosphate, PTH, and FGF-23 in individuals undergoing TPE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Measurements were taken immediately before, immediately after, and at follow-up. Paired t tests compared the percentage changes in metabolites from pre- to post-TPE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Study participants (N = 42) had a mean age of 55 \u00b1 16\u2005years, 28 (67%) were female, and 32 (76%) were White. TPE led to acute changes in calcium (\u22129%; 95% CI, \u221211% to \u22128%), phosphate (\u221214%; \u221218% to \u221211%), and FGF-23 (\u221212%; \u221218% to \u22126%) concentrations. In contrast, PTH levels increased (91%; 63%-119%) from baseline to post-TPE. While most metabolites returned to baseline by the follow-up visit (median 4 [interquartile range, 3-7] days), nearly 25% of patients experienced persistent asymptomatic hypocalcemia. This persistent calcium deficit was not fully corrected by continuous intravenous calcium gluconate infusions administered during the study, nor by the endogenously increased PTH levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These findings underscore the need for improved care protocols and vigilant monitoring of mineral metabolism in TPE patients, especially those receiving long-term treatment. Further research is warranted to understand the enduring effects of TPE on mineral metabolism and develop strategies to prevent complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgaf400","type":"journal-article","created":{"date-parts":[[2025,7,15]],"date-time":"2025-07-15T13:14:23Z","timestamp":1752585263000},"page":"e447-e454","source":"Crossref","is-referenced-by-count":2,"title":["Therapeutic Plasma Exchange and Changes in Calcium, Phosphate, Parathyroid Hormone, and Fibroblast Growth Factor-23"],"prefix":"10.1210","volume":"111","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5832-4026","authenticated-orcid":false,"given":"Sami SeungMi","family":"Jin","sequence":"first","affiliation":[{"name":"School of Medicine, University of California San Diego , 9452 Medical Center Dr, L3E206, La Jolla, CA 92037 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