Baseline PTH, phosphate, prior hypercalcemia, and dialysate calcium concentration were major predictors in the model.<h4>Conclusions</h4>In adjusted longitudinal analyses, hydrochloric acid-based bicarbonate dialysate was associated with a steeper decline in pre-dialysis PTH over two years compared with acetate, while citrate did not differ from acetate. Here, PTH is linked to hypercalcemia disease.