Optimum dialysate calcium concentration during maintenance hemodialysis.

A dialysate calcium concentration of 7 mg/100 ml is optimal for hemodialysis. Provided plasma phosphate concentrations are maintained within the normal range and provided that thrice weekly dialysis is employed, this concentration of calcium in the dialysate restores plasma-ionized calcium level to normal, provides sufficient calcium during dialysis to offset loss of calcium in the stool, and prevents loss of calcium from bone. Several clinical trials indicate that it reduces the risk of progressive secondary hyperparathyroidism. Normalization of plasma calcium and phosphate levels reduces (but does not eliminate) the risk of metastatic calcification.