Abstract: [Abstract]    Objective   To observe the changes of serum calcium, phosphorus, calcium-phosphorus product and parathyroid hormone（PTH） levels after treatment with different concentrations of calcium dialysate in combination with calcitriol. Methods    Thirty-six patients on maintenance hemodialysis were randomly divided into Dca1.25 group and Dca1.5 group, 18 cases in each group. Patients took different doses of calcitriol on the different values of PTH basis. Changes of serum calcium, phosphorus, calcium-phosphorus product， PTH and bone alkaline phosphatase (BAP) levels were recorded respectively on four time points from prior treatment and 1, 3 and 6 months of therapy. The levels of systolic blood pressure(SBP) and diastolic blood pressure (DBP) were also observed. Results   There was an interaction between treatment effects and time effects in serum calcium, phosphorus, calcium-phosphorus product levels in two groups (P < 0.05). With the duration of treatment, there was a trended to decrease and increase respectively in DCa 1.25 group and DCa 1.5 group, and trended to stabilize for therapy 3 to 6 months. There was no interaction between serum PTH and BAP levels and time effects in two groups. There was no statistical difference in simple treatment effects and time effects. The serum PTH level showed a trend of increase gradually in DCa1.5 group with the duration of treatment. In DCa 1.25 group, the serum PTH level trended to stabilize after 3-month therapy and showed a trend of decrease gradually. There was an interaction between treatment effects and time effects in SBP in two groups, but no interaction in DBP. There was a significant difference in SBP before and after treatment in two groups. The level of SBP reduced tardily with time of treatment and reduced significantly after 3 and 6 -month therapy. Conclusion The application of DCa1.25 dialysate in combination with calcitriol decreased serum calcium effectively and kept the lower limit of normal value, which increased tolerability of active vitamin D and calcium carbonate therapy, and decreased SBP in maintenance hemodialysis patients.

Key words: hemodialysis solutions, hypercalcemia, parathyroid hormone-related protein, calcium, phosphate, Alkaline Phosphatase, Blood Pressure, 骨化三醇