1. The KDIGO guideline for dialysate calcium will result in an increased incidence of calcium accumulation in hemodialysis patients 
Frank A. Gotch, Peter Kotanko, Stephan Thijssen, Nathan W. Levin 
Kidney International 
Volume 78, Issue 4, Pages (August 2010)
DOI: /ki
Copyright © 2010 International Society of Nephrology Terms and Conditions

2. Figure 1
Illustration of intradialytic flux analyses that led to mathematical prediction of a large calcium buffer pool supporting plasma calcium concentration during diffusive dialyzer calcium flux.
Kidney International  , DOI: ( /ki )
Copyright © 2010 International Society of Nephrology Terms and Conditions

3. Figure 2
The magnitude of buffering of change in plasma Ca++ by the calcium buffer pool. (a) Depicts the analysis of the Hou data9 with CdiCa mEq/l described further in the text. (b) Depicts the close relationship of modeled to measured Ca++ flux in the Hou and Nolph data10 discussed further in the text.
Kidney International  , DOI: ( /ki )
Copyright © 2010 International Society of Nephrology Terms and Conditions

4. Figure 3
Values measured for KMP at the Renal Research Institute (RRI) and the two values calculated from the Hou data.9 Note that on average 76% of net calcium flux was from the miscible calcium pool over an observed range of −500 to +800mg.
Kidney International  , DOI: ( /ki )
Copyright © 2010 International Society of Nephrology Terms and Conditions

5. Figure 4
Calcium absorption as a function of CaINT and dose of vitamin D analogs. In (a) the points calculated for 320 hemodialysis patients are plotted for total calcium intake (diet plus Ca(Ac)2) and for calcium intake from diet alone. In addition a dietary calcium intake of 800mg/day as recommended by Moe18 is also depicted. In (b) cumulative frequency curves of CaAbs for the three categories of data in (a) are shown.
Kidney International  , DOI: ( /ki )
Copyright © 2010 International Society of Nephrology Terms and Conditions

6. Figure 5
Cumulative frequency curves are shown for required CdiCa++ to achieve zero CaMB calculated from the CaAbs curves inFigure 4and compared to the KDIGO guideline for CdiCa++. Note that on curves 1 (Ca(Ac)2) and 2 (Diet CaINT 800mg/day only) 70 and 50% of patients, respectively, will have calcium accumulation with CdiCa mEq/l. On curve 3, with tightly controlled dietary Ca intake only 20% of patients are predicted to be in positive CaMB and about 15% will have negative CaMB with a maximal CdiCa++ of 3.00mEq/l.
Kidney International  , DOI: ( /ki )
Copyright © 2010 International Society of Nephrology Terms and Conditions

7. Figure 6
Calculations of CaAbs in a simulated study comparing a non-Ca-based (sevelamer) to a Ca-based (Ca(Ac)2) binder. In (a) CaINT levels of 500 and 1500mg/day and a vitamin D analog dose of 6μg/dialysis are assumed and depicted. Note that CaAbs will be about 100mg/day with sevelamer and 200mg/day with Ca(Ac)2 at the level of CaINT and dose of vitamin D analog. In (b) solutions of the CaMB model for CdiCa++ required to achieve zero mass balance are shown for the absorption curves in (a). The two simulated study data points in (b) show that in the case of sevelamer the required CdiCa++ is 2.3mEq/l whereas for Ca(Ac)2 it must be lowered to 2.0mEq/l for these study parameters. The dotted arrows indicate the large changes in CdiCa++, which would be required for zero CaMB when the doses of Vit D3 analogs are changed during a study.
Kidney International  , DOI: ( /ki )
Copyright © 2010 International Society of Nephrology Terms and Conditions