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It has been suggested that using the iPTH value, rather than the Ca and PO4 values, to guide the dialysate Ca and PO4 concentrations, will reduce the risk of toxic levels of Ca and PO4 and subsequent serum concentrations of Ca and PO4. Also, in an attempt to minimize the potential for over correction of hyperparathyroidism during nocturnal HD, the Ca and PO4 concentrations are normally titrated more conservatively in dialysate in the clinic than in home HD. In this study, a remote clinic was used which would have the benefit of the titration of Ca and PO4 concentrations in the clinic to avoid excessive correction of hyperparathyroidism during nocturnal HD. This could be done in the past but is not typically done in the clinic in order to minimize the potential for iatrogenic hypercalcemia and hypophosphatemia. In this study, nearly all of the patients were given a serum Ca in the allowable range for serum Ca ( 827ec27edc