{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:13:33Z","timestamp":1788261213358,"version":"build-2803163510"},"reference-count":125,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2013,3,22]],"date-time":"2013-03-22T00:00:00Z","timestamp":1363910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The survival rate of dialysis patients, as determined by risk factors such as hypertension, nutritional status, and chronic inflammation, is lower than that of the general population. In addition, disorders of bone mineral metabolism are independently related to mortality and morbidity associated with cardiovascular disease and fracture in dialysis patients. Hyperphosphatemia is an important risk factor of, not only secondary hyperparathyroidism, but also cardiovascular disease. On the other hand, the risk of death reportedly increases with an increase in adjusted serum calcium level, while calcium levels below the recommended target are not associated with a worsened outcome. Thus, the significance of target levels of serum calcium in dialysis patients is debatable. The consensus on determining optimal parathyroid function in dialysis patients, however, is yet to be established. Therefore, the contribution of phosphorus and calcium levels to prognosis is perhaps more significant. Elevated fibroblast growth factor 23 levels have also been shown to be associated with cardiovascular events and death. In this review, we examine the associations between mineral metabolic abnormalities including serum phosphorus, calcium, and parathyroid hormone and mortality in dialysis patients.<\/jats:p>","DOI":"10.3390\/nu5031002","type":"journal-article","created":{"date-parts":[[2013,3,22]],"date-time":"2013-03-22T12:44:31Z","timestamp":1363956271000},"page":"1002-1023","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":38,"title":["Mineral Metabolic Abnormalities and Mortality in  Dialysis Patients"],"prefix":"10.3390","volume":"5","author":[{"given":"Masanori","family":"Abe","sequence":"first","affiliation":[{"name":"Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine,  Nihon University School of Medicine, 30-1, Oyaguchi Kami-chou, Itabashi-ku, Tokyo 173-8610, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuyoshi","family":"Okada","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Hypertension and Endocrinology, Department of Internal Medicine,  Nihon University School of Medicine, 30-1, Oyaguchi Kami-chou, Itabashi-ku, Tokyo 173-8610, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayoshi","family":"Soma","sequence":"additional","affiliation":[{"name":"Division of General Medicine, Department of Internal Medicine, Nihon University School of Medicine, 30-1, Oyaguchi Kami-chou, Itabashi-ku, Tokyo 173-8610, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2013,3,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1945","DOI":"10.1038\/sj.ki.5000414","article-title":"Definition, evaluation, and classification of renal osteodystrophy: A position statement from Kidney Disease: Improving Global Outcomes (KDIGO)","volume":"69","author":"Moe","year":"2006","journal-title":"Kidney Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1093\/ndt\/gfm048","article-title":"Changing the current terminology in medicine always a challenge","volume":"22","year":"2007","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2513","DOI":"10.1093\/ndt\/gfl257","article-title":"Mineral metabolism and cardiovascular morbidity and mortality risk: Peritoneal dialysis patients compared with haemodialysis patients","volume":"21","author":"Noordzij","year":"2006","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"S112","DOI":"10.1053\/ajkd.1998.v32.pm9820470","article-title":"Clinical epidemiology of cardiovascular disease in chronic renal disease","volume":"32","author":"Foley","year":"1998","journal-title":"Am. J. Kidney Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1097\/01.ASN.0000133041.27682.A2","article-title":"Mineral metabolism, mortality, and morbidity in maintenance hemodialysis","volume":"15","author":"Block","year":"2004","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1179","DOI":"10.1111\/j.1523-1755.2005.00185.x","article-title":"Predictors and consequences of altered mineral metabolism: The Dialysis Outcomes and Practice Patterns Study","volume":"67","author":"Young","year":"2005","journal-title":"Kidney Int."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2131","DOI":"10.1681\/ASN.V12102131","article-title":"Association of elevated serum PO(4), Ca \u00d7 PO(4) product, and parathyroid hormone with cardiac mortality risk in chronic hemodialysis patients","volume":"12","author":"Genesh","year":"2001","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1097\/01.ASN.0000113243.24155.2F","article-title":"Calcium, phosphate, and parathyroid hormone levels in combination and as a function of dialysis duration predict mortality: evidence for the complexity of the association between mineral metabolism and outcomes","volume":"15","author":"Stevens","year":"2004","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"607","DOI":"10.1053\/ajkd.1998.v31.pm9531176","article-title":"Association of serum phosphorus and calcium \u00d7 phosphorus product with mortality risk in chronic hemodialysis patients: A national study","volume":"31","author":"Block","year":"1998","journal-title":"Am. J. Kidney Dis."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1681\/ASN.2004040275","article-title":"Calcium, phosphorus, parathyroid hormone, and cardiovascular disease in hemodialysis patients: the USRDS waves 1, 3, and 4 study","volume":"16","author":"Slinin","year":"2005","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1681\/ASN.2004070602","article-title":"Serum phosphate levels and mortality risk among people with chronic kidney disease","volume":"16","author":"Kestenbaum","year":"2005","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1038\/sj.ki.5001542","article-title":"Changes in serum calcium, phosphate, and PTH and the risk of death in incident dialysis patients: A longitudinal study","volume":"70","author":"Melamed","year":"2006","journal-title":"Kidney Int."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1038\/sj.ki.5001514","article-title":"Survival predictability of time-varying indicators of bone disease in maintenance hemodialysis patients","volume":"70","author":"Kuwae","year":"2006","journal-title":"Kidney Int."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1658","DOI":"10.1093\/ndt\/gfm008","article-title":"Hypercalcaemia is associated with poor mental health in haemodialysis patients: Results from Japan DOPPS","volume":"22","author":"Tanaka","year":"2007","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/S0272-6386(12)70364-5","article-title":"Death risk in hemodialysis patients: The predictive value of commonly measured variables and an evaluation of death rate differences between facilities","volume":"15","author":"Lowrie","year":"1990","journal-title":"Am. J. Kidney Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1159\/000169030","article-title":"Hypocalcemia, morbidity, and mortality in end-stage renal disease","volume":"16","author":"Foley","year":"1996","journal-title":"Am. J. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1358","DOI":"10.1038\/sj.ki.5001754","article-title":"Incidence and risk factors for hip or other bone fractures among hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study","volume":"70","author":"Jadoul","year":"2006","journal-title":"Kidney Int."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1053\/j.ajkd.2005.09.024","article-title":"PTH and the risks for hip, vertebral, and pelvic fractures among patients on dialysis","volume":"47","author":"Danese","year":"2006","journal-title":"Am. J. Kidney Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1038\/sj.ki.5002177","article-title":"The Kidney Disease: Improving Global Outcomes website: Comparison of guidelines as a tool for harmonization","volume":"71","author":"Vanbelleghem","year":"2007","journal-title":"Kidney Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"S15","DOI":"10.1093\/ndt\/15.suppl_5.15","article-title":"Pathogenesis, prevention and management of low-bone turnover","volume":"15","year":"2000","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_21","unstructured":"(2006). Chronic Kidney Disease in Adults: UK Guidelines for Identification, Management and Referral, Royal College of Physicians."},{"key":"ref_22","unstructured":"(2003). K\/DOQI clinical practice guidelines. Am. J. Kidney Dis., 42, S1\u2013S202."},{"key":"ref_23","first-page":"S1","article-title":"Hemodialysis clinical practice guidelines for the Canadian Society of Nephrology","volume":"17","author":"Jindal","year":"2006","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"S230","DOI":"10.1111\/j.1440-1797.2006.00508.x","article-title":"Management of bone disease, calcium phosphate and parathyroid hormone","volume":"11","author":"Elder","year":"2006","journal-title":"Nephrology."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"519","DOI":"10.1053\/j.ajkd.2008.03.020","article-title":"Mortality risk for dialysis patients with different levels of serum calcium, phosphorus, and PTH: The Dialysis Outcomes and Practice Patterns Syudy (DOPPS)","volume":"52","author":"Tentori","year":"2008","journal-title":"Am. J. Kidney Dis."},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"(2008). Clinical practice guideline for the management of secondary hyperparathyroidism in chronic dialysis patients. Ther. Aphel. Dial., 12, 514\u2013525.","DOI":"10.1111\/j.1744-9987.2008.00648.x"},{"key":"ref_27","unstructured":"(2009). KDIGO clinical practice guideline for the diagnosis, evaluation, prevention, and treatment of Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD). Kidney Int. Suppl., 76, S50\u2013S99."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1478","DOI":"10.1056\/NEJM200005183422003","article-title":"Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis","volume":"342","author":"Goodman","year":"2000","journal-title":"N. Engl. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"324","DOI":"10.1046\/j.1523-1755.2001.00803.x","article-title":"Risk factors and mortality associated with calciphylaxis in end-stage renal disease","volume":"60","author":"Mazhar","year":"2001","journal-title":"Kidney Int."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1267","DOI":"10.1053\/ajkd.2001.24533","article-title":"Calciphylaxis is associated with hyperphosphatemia and increased osteopontin expression by vascular smooth muscle cells","volume":"37","author":"Ahmed","year":"2001","journal-title":"Am. J. Kidney Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1093\/ndt\/15.7.1014","article-title":"Arterial stiffening and vascular calcifications in end-stage renal disease","volume":"15","author":"Guerin","year":"2000","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1161\/hy1001.096358","article-title":"Arterial calcifications, arterial stiffness, and cardiovascular risk in end-stage renal disease","volume":"38","author":"Blacher","year":"2001","journal-title":"Hypertension"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"E10","DOI":"10.1161\/01.RES.87.7.e10","article-title":"Phosphate regulation of vascular smooth muscle cell calcification","volume":"87","author":"Jono","year":"2000","journal-title":"Circ. Res."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2178","DOI":"10.1093\/ndt\/14.9.2178","article-title":"Association of hyperphosphatemia with haemodynamic disturbances in end-stage renal disease","volume":"14","author":"Marchais","year":"1999","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.jjcc.2011.10.003","article-title":"Determinants of progression of aortic valve stenosis and outcome of adverse events in hemodialysis patients","volume":"59","author":"Hoshina","year":"2012","journal-title":"J. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1662","DOI":"10.1093\/ndt\/gfq582","article-title":"Progression of aortic calcification is associated with disorders of mineral metabolism and mortality in chronic dialysis patients","volume":"26","author":"Noordzij","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"925","DOI":"10.1053\/j.ajkd.2005.08.013","article-title":"The Kidney Disease Outcomes Quality Initiative (K\/DOQI) Guideline for Bone Metabolism and Disease in CKD: association with mortality in dialysis patients","volume":"46","author":"Noordzij","year":"2005","journal-title":"Am. J. Kidney Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1053\/j.ajkd.2005.04.006","article-title":"Mild hyperphosphatemia and mortality in hemodialysis patients","volume":"46","author":"Rodriguez","year":"2005","journal-title":"Am. J. Kidney Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1111\/j.1744-9987.2007.00540.x","article-title":"Effects of serum levels of calcium, phosphorus, and intact PTH on survival in Chronic Hemodialysis Patients in Japan","volume":"12","author":"Nakai","year":"2008","journal-title":"Ther. Apher. Dial."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S1051-2276(98)90046-2","article-title":"Relationship between serum phosphorus levels and various outcome measures in adult hemodialysis patients","volume":"8","author":"Greene","year":"1998","journal-title":"J. Ren. Nutr."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1046\/j.1525-139X.2003.16037.x","article-title":"Hidden sources of phosphorus in the typical American diet: Does it matter in Nephrology?","volume":"16","author":"Uribarri","year":"2003","journal-title":"Semin. Dial."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"641","DOI":"10.1016\/S0272-6386(97)90352-8","article-title":"Are we mismanaging calcium and phosphate metabolism in renal failure?","volume":"29","author":"Hsu","year":"1997","journal-title":"Am. J. Kidney Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1268","DOI":"10.1016\/S0002-8223(96)00331-8","article-title":"Regression equation predicts dietary phosphorus intake from estimate of dietary protein intake","volume":"96","author":"Boaz","year":"1996","journal-title":"J. Am. Diet. Assoc."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1053\/j.jrn.2005.11.001","article-title":"Enhanced foods: Hidden phosphorus and sodium in foods commonly eaten","volume":"16","author":"Karalis","year":"2006","journal-title":"J. Ren. Nutr."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"303","DOI":"10.1053\/j.jrn.2010.06.021","article-title":"Extra-phosphate load from food additives in commonly eaten foods: a real and insidious danger for renal patients","volume":"21","author":"Benini","year":"2011","journal-title":"J. Ren. Nutr."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1053\/j.jrn.2011.12.010","article-title":"Novel differential measurement of natural and added phosphorus in cooked ham with or without preservatives","volume":"22","author":"Cupisri","year":"2012","journal-title":"J. Ren. Nutr."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"629","DOI":"10.1001\/jama.2009.96","article-title":"Effect of food additives on hyperphosphatemia among patients with end-stage renal disease","volume":"301","author":"Sullivan","year":"2009","journal-title":"JAMA"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1056\/NEJMoa0706130","article-title":"Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis","volume":"359","author":"Gutierrez","year":"2008","journal-title":"N. Engl. J. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/S0272-6386(04)01103-5","article-title":"Magnitude and impact of abnormal mineral metabolism in hemodialysis patients in the Dialysis Outcomes and Practice Patterns Study (DOPPS)","volume":"44","author":"Young","year":"2004","journal-title":"Am. J. Kidney Dis."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1111\/j.1542-4758.2007.00190.x","article-title":"Association of mineral metabolism factors with all-cause and cardiovascular mortality in hemodialysis patients: the Japan dialysis outcomes and practice patterns study","volume":"11","author":"Kimata","year":"2007","journal-title":"Hemodial. Int."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1053\/j.ajkd.2008.05.020","article-title":"Disordered mineral metabolism in hemodialysis patients: An ananlysis of cumulative effects in the hemodialysis (HEMO) Study","volume":"52","author":"Wald","year":"2008","journal-title":"Am. J. Kidney Dis."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1159\/000319861","article-title":"Association of cumulatively low or high serum calcium levels with mortality in long-term hemodialysis patients","volume":"32","author":"Miller","year":"2010","journal-title":"Am. J. Nephrol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1093\/ndt\/gfq304","article-title":"Calcium, phosphorus, PTH and death rates in a large sample of dialysis patients from Latin America. The CORES Study","volume":"26","author":"Guinsburg","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"552","DOI":"10.1159\/000045869","article-title":"Refeeding hypophosphatemia in a chronically hyperphophatemic hemodialysis patient","volume":"86","author":"Koch","year":"2000","journal-title":"Nephron"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/0272-6386(95)90599-5","article-title":"Predictive value of serum parathyroid hormone levels for bone turnover in patients on chronic maintenance dialysis","volume":"26","author":"Qi","year":"1995","journal-title":"Am. J. Kidney Dis."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1434","DOI":"10.1038\/ki.1995.201","article-title":"Bone disease in predialysis, hemodialysis, and CAPD patients: evidence of a better bone response to PTH","volume":"47","author":"Torres","year":"1995","journal-title":"Kidney Int."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/0272-6386(95)90453-0","article-title":"Relationship between intact 1\u201384 parathyroid hormone and bone histomorphometric parameters in dialysis patients without albumin toxicity","volume":"26","author":"Wang","year":"1995","journal-title":"Am. J. Kidney Dis."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1159\/000189578","article-title":"Assessment of renal osteodystrophy in dialysis patients: use of bone alkaline phosphatase, bone mineral density and parathyroid ultrasound in comparison with bone histology","volume":"75","author":"Fletcher","year":"1997","journal-title":"Nephron"},{"key":"ref_59","first-page":"224","article-title":"Can bone histomorphometry be predicted by clinical assessment and noninvasive techniques in peritoneal dialysis?","volume":"22","author":"Joffe","year":"1996","journal-title":"Miner. Electrolyte Metab."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"S20","DOI":"10.1046\/j.1523-1755.1999.07313.x","article-title":"The role of bone biopsy in clinical practice and research","volume":"73","author":"Malluche","year":"1999","journal-title":"Kidney Int."},{"key":"ref_61","first-page":"145","article-title":"Intact parathyroid hormone overestimates the presence and severity of parathyroid-mediated osseous abnormalities in uremia","volume":"75","author":"Quarles","year":"1992","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"284","DOI":"10.5414\/CNP63284","article-title":"New worldwide trends in presentation of renal osteodystrophy and its relationship to parathyroid hormone levels","volume":"63","author":"Popovtzer","year":"2005","journal-title":"Clin. Nephrol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1053\/ajkd.2000.19812","article-title":"Incresed incidence of hip fractures in dialysis patients with low serum parathyroid hormone","volume":"36","author":"Coco","year":"2000","journal-title":"Am. J. Kidney Dis."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1053\/ajkd.1998.v32.pm9808139","article-title":"Pathogenic, clinical, and therapeutic aspects of secondary hyperparathyroidism in chronic renal failure","volume":"32","author":"Llach","year":"1998","journal-title":"Am. J. Kidney Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"S14","DOI":"10.1046\/j.1523-1755.1999.07304.x","article-title":"Pathogenesis of secondary hyperparathyroidism","volume":"73","author":"Slatopolsky","year":"1999","journal-title":"Kidney Int."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1046\/j.1523-1755.1999.0550031019.x","article-title":"Serum levels of 1,25-dihydroxyvitamin D, 24,25-dihydroxyvitamin D, and 25-hydroxyvitamin D in nondialyzed patients with chronic renal failure","volume":"55","author":"Ishimura","year":"1999","journal-title":"Kidney Int."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1093\/ndt\/17.2.336","article-title":"Cardiovascular calcification in end-stage renal disease","volume":"17","author":"Salusky","year":"2002","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_68","first-page":"371","article-title":"Ecologic studies of solar UV-B radiation and cancer mortality rates","volume":"164","author":"Grant","year":"2003","journal-title":"Cancer Res."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"1673","DOI":"10.1016\/S0140-6736(00)04831-5","article-title":"25-hydroxyvitamin D-1alpha-hydroxylase in normal and malignant colon tissue","volume":"357","author":"Tangpricha","year":"2001","journal-title":"Lancet"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1093\/infdis\/169.4.889","article-title":"Subnormal serum concentration of 1,25-vitamin D in human immunodeficiency virus infection: correlation with degree of immune deficiency and survival","volume":"169","author":"Haug","year":"1994","journal-title":"J. Infect. Dis."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1093\/ajcn\/85.6.1586","article-title":"Vitamin D and calcium supplementation reduces cancer risk: results of a randomized trial","volume":"85","author":"Lappe","year":"2007","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1115","DOI":"10.1681\/ASN.2004070573","article-title":"Activated injectable vitamin D and hemodialysis survival: A historical cohort study","volume":"16","author":"Teng","year":"2005","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"1858","DOI":"10.1038\/sj.ki.5001868","article-title":"Medical Directors of Dialysis Clinic Inc. Mortality risk among hemodialysis patients receiving different vitamin D analogs","volume":"70","author":"Tentori","year":"2006","journal-title":"Kidney Int."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1038\/ki.2008.343","article-title":"Oral active vitamin D is associated with improved survival in hemodialysis patients","volume":"74","author":"Guinsburg","year":"2008","journal-title":"Kidney Int."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1056\/NEJMoa022536","article-title":"Survival patients undergoing hemodialysis with paricalcitol or calcitriol therapy","volume":"349","author":"Teng","year":"2003","journal-title":"N. Engl. J. Med."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"963","DOI":"10.1093\/ndt\/gfn592","article-title":"The survival advantage for haemodialysis patients taking vitamin D is questioned: Findings from the Dialysis Outcomes and Practice Patterns Study","volume":"24","author":"Tentori","year":"2009","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1172\/JCI111639","article-title":"Marked suppression of secondary hyperparathyroidism by intravenous administration of 1,25-dihydroxy-cholecalciferol in uremic patients","volume":"74","author":"Slatopolsky","year":"1984","journal-title":"J. Clin. Invest."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1093\/ndt\/17.suppl_10.10","article-title":"Vitamin D analogues for secondary hyperparathyroidism","volume":"17","author":"Brown","year":"2002","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1111\/j.1744-9987.2005.00296.x","article-title":"Maxacalcitol is a possible less phosphatemic vitamin D analogue","volume":"9","author":"Kazama","year":"2005","journal-title":"Ther. Apher. Dial."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1046\/j.1523-1755.1999.00240.x","article-title":"REnaGel, a nonabsorbed calcium- and albumin-free phosphate binder, lowers serum phosphorus and parathyroid hormone. The Renagel Study Group","volume":"55","author":"Slatopolsky","year":"1999","journal-title":"Kidney Int."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1111\/j.1774-9987.2005.00215.x","article-title":"Combination therapy with sevelamer hydrochloride and calcium carbonate in Japanese patients with long-term hemodialysis: Alternative approach for optimal mineral management","volume":"9","author":"Ogata","year":"2005","journal-title":"Ther. Aphel. Dial."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"c3","DOI":"10.1159\/000075565","article-title":"Effects of reduced dialysate calcium on calcium-phosphorus product and bone metabolism in hemodialysis patients","volume":"96","author":"Fiedler","year":"2004","journal-title":"Nephron. Clin. Pract."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.bone.2005.02.008","article-title":"Impact of lowering dialysate calcium concentration on serum bone turnover markers in hemodialysis patients","volume":"36","author":"Hamano","year":"2005","journal-title":"Bone"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1038\/366575a0","article-title":"Cloning and characterization of an extracellular Ca(s+)-sensing receptor from bovine parathyroid","volume":"366","author":"Brown","year":"1993","journal-title":"Nature"},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1152\/physrev.2001.81.1.239","article-title":"Extracellular calcium sensing and extracellular calcium signaling","volume":"81","author":"Brown","year":"2001","journal-title":"Physiol. Rev."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"627","DOI":"10.1124\/jpet.103.057273","article-title":"Pharmacodynamics of the type II calcimimetic compound cinacalcet HCl","volume":"308","author":"Nemeth","year":"2004","journal-title":"J. Pharmacol. Exp. Ther."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1053\/j.ajkd.2006.01.015","article-title":"Meta-analysis of biochemical and patient-level effects of calcimimetic therapy","volume":"47","author":"Strippoli","year":"2006","journal-title":"Am. J. Kidney Dis."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"462","DOI":"10.1161\/hs0202.103071","article-title":"Stroke is associated with coronary calcification as detected by electron-beam CT: The Rotterdam Coronary Calcification Study","volume":"33","author":"Vliegenthart","year":"2002","journal-title":"Stroke"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1053\/euhj.2002.3240","article-title":"Coronary calcification detected by electron-beam computed tomography and myocardial infarction. The Rotterdam Coronary Calcification Study","volume":"23","author":"Vliegenthart","year":"2002","journal-title":"Eur. Heart. J."},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.annepidem.2003.09.009","article-title":"The association of Rose questionnaire angina pectoris and coronary calcification in a general population: the Rotterdam Coronary Calcification Study","volume":"14","author":"Oei","year":"2004","journal-title":"Ann. Epidemiol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"S119","DOI":"10.1046\/j.1523-1755.63.s85.28.x","article-title":"Vascular calcification in the uremic patient: A cardiovascular risk?","volume":"63","author":"Salgueira","year":"2003","journal-title":"Kidney Int. Suppl."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1159\/000325656","article-title":"INDEPENDENT study investigators. Coronary artery calcification progression is associated with arterial stiffness and cardiac repolarization deterioration in hemodialysis patients","volume":"34","author":"Nargi","year":"2011","journal-title":"Kidney Blood Press. Res."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"2293","DOI":"10.1111\/j.1523-1755.2004.66015.x","article-title":"Elevated extracellular calcium levels induce smooth muscle cell matrix mineralization in vitro","volume":"66","author":"Young","year":"2004","journal-title":"Kidney Int."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1681\/ASN.2006050490","article-title":"Reversal of the adynamic bone disorder and decreased vascular calcification in chronic kidney disease by sevelamer carbonate therapy","volume":"18","author":"Mathew","year":"2007","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1097\/01.ASN.0000025782.24383.0D","article-title":"The effects of sevelamer hydrochloride and calcium carbonate on kidney calcification in uremic rats","volume":"13","author":"Cozzolino","year":"2002","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_96","doi-asserted-by":"crossref","unstructured":"Louvet, L., Buchel, J., Steppan, S., Passlick-Deetjen, J., and Masst, Z.A. (2012). Magnesium prevents phosphate-induced calcification in human aortic vascular smooth muscle cells. Nephrol. Dial. Transplant., in press.","DOI":"10.1093\/ndt\/gfs520"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1097\/01.ASN.0000038685.95946.83","article-title":"Cardiac valve calcification as an important predictor for allcause mortality and cardiovascular mortality in long-term peritoneal dialysis patients: A prospective study","volume":"14","author":"Wang","year":"2003","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1016\/j.atherosclerosis.2006.03.033","article-title":"Mitral annular calcification predicts mortality and coronary artery disease in end stage renal disease","volume":"191","author":"Sharma","year":"2007","journal-title":"Atherosclerosis"},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"742","DOI":"10.1016\/j.amjcard.2004.11.025","article-title":"Prevalence of valve calcium and association of valve calcium with coronary artery disease, atherosclerotic vascular disease, and all-cause mortality in 137 patients undergoing hemodialysis for chronic renal failure","volume":"95","author":"Varma","year":"2005","journal-title":"Am. J. Cardiol."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.2215\/CJN.02190507","article-title":"Progressive vascular calcification over 2 years is associated with arterial stiffening and increased mortality in patients with stages 4 and 5 chronic kidney disease","volume":"2","author":"Sigrist","year":"2007","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1177\/2040622311433771","article-title":"Sevelamer for hyperphosphatemia in kidney failure: Controversy and perspective","volume":"3","author":"Cozzolino","year":"2012","journal-title":"Ther. Adv. Chronic Dis."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"487","DOI":"10.2215\/CJN.03820411","article-title":"INDEPENDENT Study Investigators. Mortality in kidney disease patients treated with phosphate binders: A randomized study","volume":"7","author":"Bellasi","year":"2012","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1046\/j.1523-1755.2002.00434.x","article-title":"Sevelamer attenuates the progression of coronary and aortic calcification in hemodialysis patients","volume":"62","author":"Chertow","year":"2002","journal-title":"Kidney Int."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"1815","DOI":"10.1111\/j.1523-1755.2005.00600.x","article-title":"Effects of sevelamer and calcium on coronary artery calcification in patients new to hemodialysis","volume":"68","author":"Block","year":"2005","journal-title":"Kidney Int."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1255","DOI":"10.1038\/sj.ki.5002518","article-title":"The progression of coronary artery calcification in predialysis patients on calcium carbonate or sevelamer","volume":"72","author":"Russo","year":"2007","journal-title":"Kidney Int."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1053\/j.ajkd.2008.02.298","article-title":"A 1-year randomized trial of calcium acetate versus sevelamer on progression of coronary artery calcification in hemodialysis patients with comparable lipid control: the Calcium Acetate Renagel Evaluation-2 (CARE-2) study","volume":"51","author":"Qunibi","year":"2008","journal-title":"Am. J. Kidney Dis."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"c273","DOI":"10.1159\/000170783","article-title":"Phosphate binder impact on bone remodeling and coronary calcification\u2014Results from the BRiC study","volume":"110","author":"Barreto","year":"2008","journal-title":"Nephron. Clin. Pract."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1038\/sj.ki.5002059","article-title":"Mortality effect of coronary calcification and phosphate binder choice in incident hemodialysis patients","volume":"71","author":"Block","year":"2007","journal-title":"Kidney Int."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1327","DOI":"10.1093\/ndt\/gfq725","article-title":"The ADVANCE study: a randomized study to evaluate the effects of cinacalcet plus low-dose vitamin D on vascular calcification in patients on hemodialysis","volume":"26","author":"Raggi","year":"2011","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1038\/ki.2009.466","article-title":"FGF23-parathyroid interaction: implications in chronic kidney disease","volume":"77","author":"Komaba","year":"2010","journal-title":"Kidney Int."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1097\/MNH.0b013e328351a391","article-title":"Fibroblast growth factor 23 and adverse clinical outcomes in chronic kidney disease","volume":"21","author":"Isakova","year":"2012","journal-title":"Curr. Opin. Nephrol. Hypertens."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"S34","DOI":"10.1038\/ki.2009.405","article-title":"Clinical relevance of FGF-23 in chronic kidney disease","volume":"76","author":"Seiler","year":"2009","journal-title":"Kidney Int. Suppl."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.1681\/ASN.2005010052","article-title":"Fibroblast growth factor-23 mitigates hyperphosphatemia but accentuates calcitriol deficiency in chronic kidney disease","volume":"16","author":"Gutierrez","year":"2005","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1097\/MAJ.0b013e3181815498","article-title":"Fibroblast growth factor 23: A possible cause of left ventricular hypertrophy in hemodialysis patients","volume":"337","author":"Hsu","year":"2009","journal-title":"Am. J. Med. Sci."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"2545","DOI":"10.1161\/CIRCULATIONAHA.108.844506","article-title":"Fibroblast growth factor 23 and left ventricular hypertrophy in chronic kidney disease","volume":"119","author":"Gutierrez","year":"2009","journal-title":"Circulation"},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1038\/ki.2010.194","article-title":"FGF-23 and vascular dysfunction in patients with stage 3 and 4 chronic kidney disease","volume":"78","author":"Yilmaz","year":"2010","journal-title":"Kidney Int."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1016\/j.bone.2012.02.634","article-title":"Intact fibroblast growth factor 23 levels predict incident cardiovascular event before but not after the start of dialysis","volume":"50","author":"Nakano","year":"2012","journal-title":"Bone"},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1053\/j.ajkd.2003.12.005","article-title":"Vascular calcification in chronic kidney disease","volume":"43","author":"Goodman","year":"2004","journal-title":"Am. J. Kidney Dis."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/S0272-6386(96)90357-1","article-title":"Prevalent left ventricular hypertrophy in the predialysis population: identifying opportunities for intervention","volume":"27","author":"Levin","year":"1996","journal-title":"Am. J. Kidney Dis."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"1506","DOI":"10.1007\/s00198-006-0154-6","article-title":"Role of fibroblast growth factor-23 in peripheral vascular calcification in nondiabetic and diabetic hemodialysis patients","volume":"17","author":"Inaba","year":"2006","journal-title":"Osteoporos. Int."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"3125","DOI":"10.1093\/ndt\/gfp205","article-title":"Relationship between circulating FGF23 and total body atherosclerosis in community","volume":"24","author":"Mirza","year":"2009","journal-title":"Nephrol. Dial. Transplant."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"385","DOI":"10.1016\/j.atherosclerosis.2009.01.001","article-title":"Circulating fibroblast growth factor-23 is associated with vascular dysfunction in the community","volume":"205","author":"Mirza","year":"2009","journal-title":"Atherosclerosis"},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"2017","DOI":"10.1007\/s00198-011-1838-0","article-title":"FGF23 is independently associated with vascular calcification but not bone mineral density in patients at various CKD stages","volume":"23","author":"Desjardins","year":"2011","journal-title":"Osteoporos. Int."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1210\/jc.2004-1039","article-title":"Fibroblast growth factor-23 relationship to dietary phosphate and renal phosphate handling in healthy young men","volume":"90","author":"Ferrari","year":"2005","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"1187","DOI":"10.1359\/jbmr.060507","article-title":"Regulation of C-terminal and intact FGF-23 by dietary phosphate in men and woman","volume":"21","author":"Burnett","year":"2006","journal-title":"J. Bone Miner. Res."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/5\/3\/1002\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T21:45:43Z","timestamp":1760219143000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/5\/3\/1002"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,3,22]]},"references-count":125,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2013,3]]}},"alternative-id":["nu5031002"],"URL":"https:\/\/doi.org\/10.3390\/nu5031002","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,3,22]]}}}