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Mineral metabolism

The perils of a falling PTH due to high dialysate calcium

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New data suggest that a fall in parathyroid hormone (PTH) 12 months after initiating haemodialysis is associated with cardiovascular death at 12–24 months. The main independent predictor for the fall in PTH is a high dialysate calcium concentration, which might not only reduce PTH but also induce vascular calcification.

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Figure 1: Effect of a high dialysate calcium (Ca) concentration on cardiovascular mortality in patients on haemodialysis.

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Acknowledgements

W.C. is supported in part by an NIH grant (grant number KL2 TR000095). D.A.B. is supported in part by an NIH grant (number 2R01DK075462). Both researchers receive grant support from the Renal Research Institute.

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Authors and Affiliations

  1. Department of Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, BOX 675, Rochester, 14642, New York, USA

    Wei Chen

  2. Department of Medicine, Pharmacology and Physiology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, BOX 675, Rochester, 14642, New York, USA

    David A. Bushinsky

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  1. Wei Chen
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Correspondence to David A. Bushinsky.

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Competing interests

D.A.B. is a consultant for Relyspa, Amgen, Sanofi/Genzyme, and Tricida and has equity interest in Relypsa, Amgen and Tricida. W.C. declares no competing interests.

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Chen, W., Bushinsky, D. The perils of a falling PTH due to high dialysate calcium. Nat Rev Nephrol 12, 264–266 (2016). https://doi.org/10.1038/nrneph.2016.36

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