ArticleAmerican journal of nephrology2010
Association of cumulatively low or high serum calcium levels with mortality in long-term hemodialysis patients.
Article in American journal of nephrology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.
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Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Is there an association between elevated or low serum levels of phosphorus, parathyroid hormone, and calcium and mortality in patients with end stage renal disease? A meta-analysis.BMC nephrology · 2013Pooled it
- Lanthanum carbonate for the treatment of hyperphosphatemia in CKD 5D: multicenter, double blind, randomized, controlled trial in mainland China.BMC nephrology · 2013Trial
- Serum calcium dynamics and risk of all-cause hospitalization and mortality in hemodialysis patients: a landmark analysis from the international DOPPS.Clinical kidney journal · 2026Article
- Hypocalcemia in Dialysis Is Not Associated with Increased Mortality: Evidence from a Population-Based Cohort.Nutrients · 2026Article
- Article
- Association between serum calcium and in-hospital mortality in critically ill atrial fibrillation patients from the MIMIC IV database.Scientific reports · 2024Article
- Serum calcium-magnesium ratio at admission predicts adverse outcomes in patients with acute coronary syndrome.PloS one · 2024Article
- Effect Modification of Kidney Function on the Non-linear Association Between Serum Calcium Levels and Cardiovascular Mortality in Korean Adults.Journal of preventive medicine and public health = Yebang Uihakhoe chi · 2023Article
- Comparative Effectiveness of Dialysis Modality on Laboratory Parameters of Mineral Metabolism.American journal of nephrology · 2022Article
- Calcium: More Than Bone? Implications for Clinical Practice and Theory.Journal of clinical medicine research · 2021Review
- Dyselectrolytemia-management and implications in hemodialysis (Review).Experimental and therapeutic medicine · 2021Review
- Impact of Changes in Serum Calcium Levels on In-Hospital Mortality.Medicina (Kaunas, Lithuania) · 2020Article
- Impact of Admission Calcium-phosphate Product on 1-year Mortality among Hospitalized Patients.Advanced biomedical research · 2020Article
- Controversies in the Management of Secondary Hyperparathyroidism in Chronic Kidney Disease.Current osteoporosis reports · 2019Review
- Article
- Dialysis Prescription and Sudden Death.Seminars in nephrology · 2018Review
- Associations between serum calcium, phosphorus and mortality among patients with coronary heart disease.European journal of nutrition · 2018Article
- Rationale to reduce calcium intake in adult patients with chronic kidney disease.Current opinion in nephrology and hypertension · 2018Review
- Role of Albumin Assay on Calcium Levels and Prescription of Phosphate Binders in Chronic Hemodialysis Patients.Nephron · 2018Article
- Evaluation of the Predictive Value of the Serum Calcium-Magnesium Ratio for All-Cause and Cardiovascular Mortality in Incident Dialysis Patients.Cardiorenal medicine · 2017Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
backgroundThe outcome-predictability of baseline and instantaneously changing serum calcium in hemodialysis patients has been examined. We investigated the mortality-predictability of time-averaged calcium values to reflect the 'cumulative' effect of calcium burden over time.
methodsWe employed a Cox model using up-to-5-year (7/2001-6/2006) time-averaged values to examine the mortality-predictability of cumulative serum calcium levels in 107,200 hemodialysis patients prior to the use of calcimimetics, but during the time where other calcium-lowering interventions, including lower dialysate calcium, were employed.
resultsBoth low (<9.0 mg/dl) and high (>10.0 mg/dl) calcium levels were associated with increased mortality (reference: 9.0 to <9.5 mg/dl). Whereas mortality of hypercalcemia was consistent, hypocalcemia mortality was most prominent with higher serum phosphorus (>3.5 mg/dl) and PTH levels (>150 pg/ml). Higher paricalcitol doses shifted the calcium range associated with the greatest survival to the right, i.e. from 9.0 to <9.5 to 9.5 to <10.0 mg/dl. African-Americans exhibited the highest death hazard ratio of hypocalcemia <8.5 mg/dl, being 1.35 (95% CI: 1.22-1.49). Both a rise and drop in serum calcium over 6 months were associated with increased mortality compared to the stable group.
conclusionsWhereas in hemodialysis patients cumulatively high or low calcium levels are associated with higher death risk, subtle but meaningful interactions with phosphorus, PTH, paricalcitol dose and race exist.
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