Seventeen patients, 11 males and 6 females, ages 39 +/- 5.37 years (range 16-63 years), with end-stage renal disease (ESRD) who had been maintained on hemodialysis (HD) for a mean period of 10.4 +/- 3.02 months were evaluated for the effects of oral CaCO3 and calcitriol on their lipid profile. All patients received a 40-g protein diet. None of the patients had a weight change or body mass index change (according to the Du Bois calculating table) at the end of the study. During the first 3 months of the study, all subjects were given aluminum-containing phosphate binders (2-3 g/day). Serum HDL, LDL, and total cholesterol, triglyceride, calcium, phosphorus, and alkaline phosphatase levels weve measured both at the beginning and at the end of the 3-month period. These measurements were repeated 3 months later following CaCO3 (3 g/day) and calcitriol (0.25 mu g/day> therapy. While serum HDL, LDL, and total cholesterol and triglyceride levels were not changed after the administration of aluminum-containing phosphate binders, serum lipid status did improve following the CaCO3 and calcitriol therapy In conclusion, three months of CaCO3 and calcitriol therapy reduced serum total cholesterol and LDL levels, and LDL/HDL ratios, and this therapy may improve the serum lipid profile to a point similar to the patient with lipid abnormalities but without renal disease.