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• W2061620194 abstract "The 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.We 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.Both 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.Whereas 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." @default.
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• W2061620194 date "2010-01-01" @default.
• W2061620194 modified "2023-10-16" @default.
• W2061620194 title "Association of Cumulatively Low or High Serum Calcium Levels with Mortality in Long-Term Hemodialysis Patients" @default.
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• W2061620194 doi "https://doi.org/10.1159/000319861" @default.
• W2061620194 hasPubMedCentralId "https://www.ncbi.nlm.nih.gov/pmc/articles/2941140" @default.
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