{"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":1790802644083,"version":"4.1.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2000,5,1]],"date-time":"2000-05-01T00:00:00Z","timestamp":957139200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2000,5,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Diabetic patients on maintenance dialysis often are characterized by a relative parathyroid hormone (PTH) deficiency and a form of renal osteodystrophy with low bone turnover known as adynamic bone. The goal of the present study was to determine whether a reduction in the dialysate calcium concentration would increase the predialysis (basal) PTH and maximal PTH level. Thirty-three diabetic maintenance hemodialysis patients with basal PTH values less than 300 pg\/ml were randomized to be dialyzed with either a regular (3.0 mEq\/liter or 3.5 mEq\/liter, group I) or low (2.25 mEq\/liter or 2.5 mEq\/liter, group II) calcium dialysate for 1 year. At baseline and after 6 months and 12 months of study, low (1 mEq\/liter) and high (4 mEq\/liter) calcium dialysis studies were performed to determine parathyroid function. At baseline, basal (I, 126 \u00b1 20 vs. II, 108 \u00b1 19 pg\/ml) and maximal (I, 269 pg\/ml \u00b1 40 pg\/ml vs. II, 342 pg\/ml \u00b1 65 pg\/ml) PTH levels were not different. By 6 months, basal (I, 98 \u00b1 18 vs. II, 200 \u00b1 34 pg\/ml, p = 0.02) and maximal (I, 276 pg\/ml \u00b1 37 pg\/ml vs. II, 529 pg\/ml \u00b1 115 pg\/ml; p = 0.05) PTH levels were greater in group II. Repeated measures analysis of variance (ANOVA) of the 20 patients who completed the entire 12-month study showed that only in group II patients were basal PTH (p = 0.01), maximal PTH (p = 0.01), and the basal\/maximal PTH ratio (p = 0.03) different; by post hoc test, each was greater (p &amp;lt; 0.05) at 6 months and 12 months than at baseline. When study values at 0,6, and 12 months in all patients were combined, an inverse correlation was present between basal calcium and both the basal\/maximal PTH ratio (r = \u22120.59; p &amp;lt; 0.001) and the basal PTH (r = \u22120.60; p &amp;lt; 0.001). In conclusion, in diabetic hemodialysis patients with a relative PTH deficiency (1) the use of a low calcium dialysate increases basal and maximal PTH levels, (2) the increased secretory capacity (maximal PTH) during treatment with a low calcium dialysate suggests the possibility of enhanced parathyroid gland growth, and (3) the inverse correlation between basal calcium and both the basal\/maximal PTH ratio and the basal PTH suggests that the steady-state PTH level is largely determined by the prevailing serum calcium concentration. (J Bone Miner Res 2000;15:927\u2013935)<\/jats:p>","DOI":"10.1359\/jbmr.2000.15.5.927","type":"journal-article","created":{"date-parts":[[2006,4,27]],"date-time":"2006-04-27T02:55:00Z","timestamp":1146106500000},"page":"927-935","source":"Crossref","is-referenced-by-count":20,"title":["Effect of a Low Calcium Dialysate on Parathyroid Hormone Secretion in Diabetic Patients on Maintenance Hemodialysis"],"prefix":"10.1093","volume":"15","author":[{"given":"Roberto","family":"Holgado","sequence":"first","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Reina Sofia, Cordoba, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Haire","sequence":"additional","affiliation":[{"name":"Dialysis Services of Florida, Fort Walton Beach, Florida, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Ross","sequence":"additional","affiliation":[{"name":"St. Francis Hospital, Wichita, Kansas, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"Sprague","sequence":"additional","affiliation":[{"name":"Department of Medicine, Evanston Hospital, Evanston, Illinois, U.S.A."},{"name":"University of Chicago, Chicago, Illinois, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madeleine","family":"Pahl","sequence":"additional","affiliation":[{"name":"University of California at Irvine, Irvine, California, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aquiles","family":"Jara","sequence":"additional","affiliation":[{"name":"Hospital Clinico, Pontificia Universidad Catolica de Chile, Santiago, Chile."},{"name":"Department of Medicine, West Los Angeles VA Medical Center and UCLA, Los Angeles, California, U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro","family":"Martin-Malo","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hospital Universitario Reina Sofia, Cordoba, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Unit of Investigation, Hospital Universitario Reina Sofia, Cordoba, Spain."},{"name":"Department of Nephrology, Hospital Universitario Reina Sofia, Cordoba, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yolanda","family":"Almaden","sequence":"additional","affiliation":[{"name":"Unit of Investigation, Hospital Universitario Reina Sofia, Cordoba, Spain."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnold J.","family":"Felsenfeld","sequence":"additional","affiliation":[{"name":"Department of Medicine, West Los Angeles VA Medical Center and UCLA, Los Angeles, California, 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