With the decline of kidney function, the kidney’s ability to excrete phosphorus decreases, while the kidney can synthesize a hormone closely related to calcium and phosphorus metabolism in the body, active vitamin D. Its level decreases in kidney failure, which will directly and indirectly affect the absorption, excretion and transfer of calcium and phosphorus, finally leading to low blood calcium and high blood phosphorus. Hemodialysis can remove phosphorus and replenish calcium, so some patients show transient improvement in blood calcium and phosphorus levels in post-dialysis labs, but this does not last the entire dialysis interval. Therefore, it is also necessary to cooperate with the doctor: 1. reduce the intake of phosphorus in the diet, such as nuts, kernels, chocolate, cola, animal protein, etc. 2, you can take some phosphorus binding agent at the same time when eating, to reduce the absorption of phosphorus, the more domestic use is calcium carbonate, other such as carbonic acid, hydrochloric acid thinking Ram is also a good choice, but the latter two are not available in China. Special circumstances such as calcium and phosphorus are very high when you can not take calcium carbonate orally, you can take aluminum hydroxide and other phosphorus binding agents containing aluminum for a short period of time, when you need to chew and take with food at the same time. 3, calcium carbonate is also the main drug for calcium, at this time often need to be separated from the diet to improve the absorption of calcium, to avoid the combination with the phosphorus in food can not be absorbed. Therefore, some patients will take calcium before and during meals at the same time, but there is a difference in the time and dose of oral intake. 4, the body regulates calcium and phosphorus metabolism in addition to active vitamin D, but also related to parathyroid hormone secreted by the parathyroid glands behind the thyroid gland in the neck, the determination of its level helps us to determine the type of renal bone disease and choose the appropriate dose and usage of active vitamin D. Especially in patients who have failed to respond to medication, have bone pain, osteoporosis, even pathological fractures, high blood calcium levels, and high parathyroid hormone, the doctor will also recommend ultrasound and nuclear imaging of the parathyroid glands to determine whether there is glandular hyperplasia or adenoma formation and whether surgery is an option.