目的 观察在将1.75mmol/L钙浓度的透析液(1.75CaD)改为使用1.50mmol/L 钙浓度透析液(1.50CaD)进行长期透析后，慢性血液透析患者钙磷代谢以及甲状旁腺激素(iPTH)水平和碱性磷酸酶(AKP)水平的变化。方法 选择首都医科大学附属北京友谊医院长期使用1.75CaD的患者，且透析前血钙正常的患者72例，观察其透析前后血钙、血磷、iPTH和AKP浓度在改用1.50CaD透析12个月后的变化情况。结果 在改用1.50CaD后，虽然透析前钙磷乘积并没有降低，但透析前、后血钙均有降低 (P值分别＜0.05和0.01)；血iPTH及AKP水平显著升高(P值分＜0.01和0.05)。结论 对于使用1.75CaD而透析前血钙正常的患者，改用1.50CaD后虽不能降低透析前钙磷乘积，但可以显著降低透析前血钙水平，减少高钙血症的发生；但应注意有促进继发性甲状旁腺功能亢进和肾性骨病发生的可能。

Objective To observer the changes of chronic hemodialysis patients’serum Ca, P, iPTH and AKP when changed dialysate calcium concentrate from 1.75mmol/L(1.75CaD) to 1.5 mmol/L(1.5CaD) for 12 months. Methods This study includes 72 patients with normal pre-dialysis serum calcium and already using 1.75 CaD for 12 months. After changing to 1.5 CaD for 12 months, we measure these patients’iPTH, AKP, and pre- and post-dialysis serum Ca, P agein. Results When we changed dialysate from 1.75CaD to 1.5 CaD, we find pre- and post-dialysis serum Ca decreased significantly(P＜0.05 and 0.01 respectively), though pre-dialysis Ca-P product did not decrease, and we observed significantly increase in iPTH and AKP(P＜0.01 and 0.05 respectively). Conclusion For these patients with normal pre-dialysis Ca, changing dialysate from 1.75CaD to 1.5CaD could reduce pre-dialysis serum Ca level, and could increase iPTH and AKP.