Objective To investigate the effects of different dialysis modalities on serum levels of dephosphorylated-uncarboxylated matrix Gla protein （dp-ucMGP）， lipid profiles， and vascular calcification in maintenance hemodialysis （MHD） patients， and to identify the risk factors associated with vascular calcification in this population. Methods A total of 87 MHD patients admitted to the hospital between January 2019 and December 2022 were enrolled as study participants. Based on their dialysis modalities， they were categorized into three groups： the hemodialysis （HD） group， the HD combined with hemodiafiltration （HD + HDF） group， and the HD， HDF combined with hemoperfusion （HD + HDF + HP） group， with 29 patients in each group. The serum dp-ucMGP levels， lipid profiles， and extent of vascular calcification were compared across the three groups. Patients were divided into a vascular calcification group and a non-vascular calcification group based on the presence or absence of vascular calcification. Univariate analyses and multivariate analysis were performed to identify factors potentially associated with vascular calcification in patients undergoing MHD. Results The results demonstrated that the levels of blood phosphorus， intact parathyroid hormone （iPTH）， serum dp-ucMGP， total cholesterol （TC）， triglycerides （TG）， and low-density lipoprotein cholesterol （LDL-C） were significantly higher in the HD group compared to the HD + HDF and HD + HDF + HP groups. Conversely， high-density lipoprotein cholesterol （HDL-C） levels were significantly lower in the HD group than in the other two groups， and all differences were statistically significant （P < 0.05）. The levels of blood phosphorus， iPTH， and serum dp-ucMGP in the HD + HDF group were significantly higher than those in the HD + HDF + HP group， with statistically significant differences （P < 0.05）. Compared with the HD group， the vascular calcification rate in the HD + HDF + HP group was significantly lower （P < 0.05）. In comparison to the non-vascular calcification group， the vascular calcification group exhibited significant increases in MHD dialysis duration， age， pulse pressure， blood phosphorus， blood calcium， iPTH， LDL-C， TC， and dp-ucMGP （P < 0.05）. Binary logistic regression analysis revealed that dialysis vintage， age， serum phosphorus， calcium， iPTH， and serum dp-ucMGP levels were independently associated with a higher risk of vascular calcification in MHD patients （P < 0.05）. Conclusions Compared with the simple HD or HD + HDF dialysis modalities， the HD + HDF + HP regimen is associated with lower levels of serum phosphorus， iPTH， dp-ucMGP， lipids， and vascular calcification prevalence in MHD patients. However， dialysis modality itself was not an independent predictor of vascular calcification. Instead， factors such as dialysis vintage， age， serum phosphorus， calcium， iPTH， and dp-ucMGP were independently associated with vascular calcification in this population.