ArticleScientific reports2020
Hidden Hypocalcemia as a Risk Factor for Cardiovascular Events and All-Cause Mortality among Patients Undergoing Incident Hemodialysis.
Article in Scientific reports, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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29 citing papers in PubMed, 46 citations in OpenAlex.
- Causal Effects of Early Discontinuation of Proton Pump Inhibitors on Kidney Failure.Kidney international reports · 2026Article
- Clinical impact of ionized calcium and hidden hypocalcemia on cardiovascular outcomes in dialysis patients.Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association · 2026Article
- Correlation and dissociation factors between ionized, total, and corrected calcium in patients undergoing hemodialysis.Clinical and experimental nephrology · 2026Article
- Risk factors and nomogram prediction model for hypocalcemia in patients undergoing hemodialysis.European journal of medical research · 2026Article
- Data subdivision approach enhances machine learning-based mortality prediction in pediatric ICU patients.PloS one · 2026Article
- Severity, etiology and outcomes of ionized hypocalcemia in azotemic cats and dogs.Frontiers in veterinary science · 2026Article
- Association Between Serum Ionized Calcium Levels and Neurological Outcomes in Patients with Out-of-Hospital Cardiac Arrest.Life (Basel, Switzerland) · 2025Article
- Exploring the association of natriuretic peptides with QTc interval in hemodialysis patients.Renal failure · 2025Article
- The different serum albumin assays influence calcium status in haemodialysis patients: a comparative study against free calcium as a reference method.Clinical chemistry and laboratory medicine · 2025Article
- Early detection of cognitive impairment in end-stage renal disease patients undergoing hemodialysis: insights from Resting-State functional connectivity analysis.BMC nephrology · 2025Article
- Kidney Allograft Rejection as an Independent Nontraditional Risk Factor for Post-Transplant Cardiovascular Events.Kidney360 · 2025Article
- Association between Parathyroid Hormone Concentration and Incident Atrial Fibrillation in Older Persons with Kidney Failure Initiating Dialysis.American journal of nephrology · 2025Article
- Switching from acetate to citrate dialysate in a central concentrate delivery system for high-volume online hemodiafiltration: a retrospective cohort study.Renal failure · 2024Article
- Prevalence and outcomes associated with hypocalcaemia and hypercalcaemia among pre-dialysis chronic kidney disease patients with mineral and bone disorder.Singapore medical journal · 2024Article
- Low-dosage active vitamin D modifies the relationship between hypocalcemia and overhydration in patients with advanced chronic kidney disease.Journal of nephrology · 2024Article
- Serum calcium is associated with sudden cardiac arrest in stroke patients from ICU: a multicenter retrospective study based on the eICU collaborative research database.Scientific reports · 2024Article
- Proton pump inhibitors and cardiovascular risk: a critical review.Future cardiology · 2024Review
- Role of Chronic Kidney Disease (CKD)-Mineral and Bone Disorder (MBD) in the Pathogenesis of Cardiovascular Disease in CKD.Journal of atherosclerosis and thrombosis · 2023Review
- 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
- A nomogram predicts cardiovascular events in patients with peritoneal dialysis-associated peritonitis.Renal failure · 2022Observational
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13 authors at 2 institutions in 1 country.
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Abstract
Lower corrected calcium (cCa) levels are associated with a better prognosis among incident dialysis patients. However, cCa frequently overestimates ionized calcium (iCa) levels. The prognostic importance of the true calcium status defined by iCa remains to be revealed. We conducted a retrospective cohort study of incident hemodialysis patients. We collected data of iCa levels immediately before the first dialysis. We divided patients into three categories: apparent hypocalcemia (low iCa; <1.15 mmol/L and low cCa; <8.4 mg/dL), hidden hypocalcemia (low iCa despite normal or high cCa), and normocalcemia (normal iCa). The primary outcome was the composite of all-cause death and cardiovascular diseases after hospital discharge. Among the enrolled 332 patients, 75% of the patients showed true hypocalcemia, defined as iCa <1.15 mmol/L, 61% of whom showed hidden hypocalcemia. In multivariate Cox models including other potential risk factors, true hypocalcemia was a significant risk factor (hazard ratio [HR], 2.34; 95% confidence interval [CI], 1.03-5.34), whereas hypocalcemia defined as corrected calcium <8.4 mg/dL was not. Furthermore, hidden hypocalcemia was significantly associated with an increased risk of the outcome compared with normocalcemia (HR, 2.56; 95% CI, 1.11-5.94), while apparent hypocalcemia was not. Patients with hidden hypocalcemia were less likely to receive interventions to correct hypocalcemia, such as increased doses of active vitamin D or administration of calcium carbonate, than patients with apparent hypocalcemia (odds ratio, 0.45; 95% CI, 0.23-0.89). Hidden hypocalcemia was a strong predictor of death and cardiovascular events, suggesting the importance of measuring iCa.
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