 Sample size calculations were based on previously reported changes in coronary artery calcification scores in hemodialysis patients during time 90 power with a two-sided, alpha error rate of 5. Four hundred fifty-seven hemodialysis patients, taking drop-out rate into consideration, will be enrolled in this prospective-controlled study.The cases already being treated with calcium-based phosphate binder and dialysate containing 1.75 or 1.5 mmolL calcium will be enrolled from eight hemodialysis centers.The cases will be randomized to two arms: 