Abstract
Background: End-stage rena1 disease (ESRD) requiring rena1 rep1acement therapy (RRT) has become a major health problem worldwide. Approximately 2.5 million people were estimated to be receiving chronic RRT in 2010. Hyperphosphatemia is one of the major clinical manifestations of decreased kidney function that is more pronounced in CKD stages 3–5. High serum phosphorus is actively involved in soft tissue and vascular calcification with increased cardiovascular disease (CVD) and mortality in these patients.
Aim and objectives: To compare calcium-based versus non-calcium-based phosphate binders concerning parameters of acid-base balance and electrolytes in hemodialysis (HD) patients from the Al-Hayah Hospital hemodialysis unit in Port Said Governorate.

Patients and methods: This prospective cohort trail was performed on 116 ESRD individuals on regular hemodialysis for at least 6 months, selected from the Al-Hayah Hospital hemodialysis unit in Port Said Governorate.
Results: At base line there were no significant difference between total Ca2+, Ionized Ca2+, HCO3, PO4-, K +and Na+ after three months of treatment total calcium levels were higher among calcium- based phosphate binders than non- calcium- based phosphate binders group with statistically significant difference. Otherwise, there were no statistically significant differences between calcium- based phosphate binders than non- calcium- based phosphate binders groups as regard ionized calcium, phosphate levels, sodium, potassium and bicarbonate levels