Effects of Dialysate Calcium Concentration on Bone, Mineral Metabolism, and Vascular Outcomes in Maintenance Hemodialysis: A Systematic Review and Meta-Analysis

Background/Objectives: The optimal dialysate calcium concentration in maintenance hemodialysis remains uncertain because reducing calcium exposure may limit calcium loading but can also stimulate parathyroid hormone secretion and impair intradialytic cardiovascular stability. We evaluated randomized evidence across bone, mineral metabolism, vascular, and acute safety outcomes.