The Effects of Different Dialysate Calcium Concentration
The Effects of Different Dialysate Calcium Concentration
The investigators enrolled 90 patients on maintenance hemodialysis with dialytic vintage ≥12
 months, iPTH 150-300pg/ml and serum calcium<2.5mmol/L. Patients were randomized to three
 groups with different dialysate calcium concentration , 1.25 mmol/L(DCa1.25),
 1.5mmol/L(DCa1.5) and 1.75 mmol/L(DCa1.75) for 24 months respectively. Hemodialysis was
 performed for 4 hours three times weekly. Serum total calcium(tCa), ionized
 calcium(iCa),intact parathyroid hormone(iPTH)and phosphorus (P) levels were recorded before
 and after the study and single dialysis session in every patient. iCa and P levels were
 measured in spent dialysate.Bone density, bone-specific alkaline phosphatase(BAP),
 osteoprotegerin(OPG)、β-crosslaps、total Procollagen Type I Intact Propeptide (P1NP）and
 vascular calcification were measured in every patient periodically. vascular calcification
 including aortic arch calcification, abdominal aorta calcification and coronary artery
 calcification were measured by chest radiography, lateral lumbar radiographs and coronary
 artery computer tomography (CT) respectively. The primary endpoints included death,
 cardio-cerebral vascular disease(defined as heart failure, myocardial infarction and stroke),
 newly nontraumatic bone fracture, secondary parathyroidism uncontrolled by medicine and
 valvular or vascular calcification. The secondary endpoint were admission or emergency
 observation.
Inclusion Criteria:

 -  Age 18-65, maintenance hemodialysis, dialytic vintage ≥12 months, iPTH 150-300pg/ml,
 serum calcium<2.5mmol/L, serum calcium<2.5mmol/L.

 Exclusion Criteria:

 -  Age<18 or >65 Severe acid-base disturbance History of parathyroid glands or adrenal
 gland combined with consumptions or malnutrition anemia due to acute bleeding or other
 diseases except for renal failure newly occurred bone fracture within 3 months active
 stage of immunological diseases using glucocorticoid or immunosuppressor combined with
 any disease with expect duration <2 year newly occurred acute heart failure, acute
 myocardial failure , acute cerebral infarction or stroke within 6 months pregnant
 women of women in preparation for pregnancy