Trial reportJournal of the American Society of Nephrology : JASN2016
Reduction of Dialysate Calcium Level Reduces Progression of Coronary Artery Calcification and Improves Low Bone Turnover in Patients on Hemodialysis.
Trial report in Journal of the American Society of Nephrology : JASN, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 4 syntheses or guidelines pooled it, 84 citations in OpenAlex.
- Adynamic bone disorder in chronic kidney disease: meta-analysis and narrative review of potential biomarkers as diagnosis and therapeutic targets.Renal failure · 2025Pooled it
- The impact of low and high dialysate calcium concentrations on cardiovascular disease and death in patients undergoing maintenance hemodialysis: a systematic review and meta-analysis.Clinical and experimental nephrology · 2024Pooled it
- Osteoporosis in Patients with Chronic Kidney Diseases: A Systemic Review.International journal of molecular sciences · 2020Pooled it
- Long-term effects of low calcium dialysates on the serum calcium levels during maintenance hemodialysis treatments: A systematic review and meta-analysis.Scientific reports · 2018Pooled it
- Dialysate calcium, alfacalcidol, and clinical outcomes: A post-hoc analysis of the J-DAVID trial.PloS one · 2022Trial
- Trial
- Higher mineralized bone volume is associated with a lower plain X-Ray vascular calcification score in hemodialysis patients.PloS one · 2017Trial
- The effects of dialysate acids and divalent ions on calcification and cardiovascular outcomes: old wisdom and new developments.Clinical kidney journal · 2026Review
- Ten tips to reduce fracture risk by non-pharmacologic interventions in CKD-associated osteoporosis.Clinical kidney journal · 2026Review
- Effects of Dialysate Calcium Concentration on Bone, Mineral Metabolism, and Vascular Outcomes in Maintenance Hemodialysis: A Systematic Review and Meta-Analysis.Diagnostics (Basel, Switzerland) · 2026Review
- Calcified coronary artery disease: Mechanisms, risk factors and clinical consequences.World journal of biological chemistry · 2026Review
- Evidence-Based Guidelines for the Diagnosis and Treatment of Pediatric CKD-Mineral and Bone Disorder (Version 2024).Kidney international reports · 2026Article
- Band keratopathy and conjunctival calcification in end-stage kidney disease: epidemiology, pathophysiology and clinical management.Clinical kidney journal · 2026Review
- Zoledronic acid for chronic kidney disease-associated osteoporosis.Archives of osteoporosis · 2026Article
- Comparative effects of 1.25 vs. 1.5 mmol/L dialysate calcium concentrations on blood pressure variability during hemodialysis: a two-center retrospective study.Frontiers in medicine · 2026Article
- Gut microbiota-derived TMAO drives the kidney-bone-vascular axis in chronic kidney disease complications.Renal failure · 2025Review
- Clinical outcomes and dialysate calcium concentrations in Chinese patients on maintenance hemodialysis: a retrospective cohort study.Renal failure · 2025Article
- Calcified Coronary Artery Disease: Pathology, Prevalence, Predictors and Impact on Outcomes.Interventional cardiology (London, England) · 2025Review
- The effects of dialysate calcium prescription on mortality outcomes in incident patients on hemodialysis.Clinical kidney journal · 2024Article
- Article
Corrections and comments
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
Abstract
Exposure to high Ca concentrations may influence the development of low-turnover bone disease and coronary artery calcification (CAC) in patients on hemodialysis (HD). In this randomized, controlled study, we investigated the effects of lowering dialysate Ca level on progression of CAC and histologic bone abnormalities in patients on HD. Patients on HD with intact parathyroid hormone levels ≤300 pg/ml receiving dialysate containing 1.75 or 1.50 mmol/L Ca (n=425) were randomized to the 1.25-mmol/L Ca (1.25 Ca; n=212) or the 1.75-mmol/L Ca (1.75 Ca; n=213) dialysate arm. Primary outcome was a change in CAC score measured by multislice computerized tomography; main secondary outcome was a change in bone histomorphometric parameters determined by analysis of bone biopsy specimens. CAC scores increased from 452±869 (mean±SD) in the 1.25 Ca group and 500±909 in the 1.75 Ca group (P=0.68) at baseline to 616±1086 and 803±1412, respectively, at 24 months (P=0.25). Progression rate was significantly lower in the 1.25 Ca group than in the 1.75 Ca group (P=0.03). The prevalence of histologically diagnosed low bone turnover decreased from 85.0% to 41.8% in the 1.25 Ca group (P=0.001) and did not change in the 1.75 Ca group. At 24 months, bone formation rate, trabecular thickness, and bone volume were higher in the 1.25 Ca group than in the 1.75 Ca group. Thus, lowering dialysate Ca levels slowed the progression of CAC and improved bone turnover in patients on HD with baseline intact parathyroid hormone levels ≤300 pg/ml.
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