WHAT IS THE APPROPRIATE DIALYSATE CALCIUM-CONCENTRATION FOR THE DIALYSIS PATIENT

Recently, there has been a trend to lower dialysate calcium concentrat ions because of the frequent occurrence of hypercalcaemia with the use of calcium-containing phosphate binders. No single dialysate calcium concentration is available which suits all dialysis patients. The risk of hypercalcaemia depends on intradialytic (diffusive and convective) calcium transport and interdialytic calcium balance (negative or posi tive intestinal balance). Low dialysate calcium concentrations expose the patient to the risks of negative calcium balance and increase in p arathyroid hormone concentration, particularly if patients are non-com pliant with the intake of calcium-containing phosphate binders.