On the morning of December 15, 2017, the haemodialysis room was busy as usual when the nurse on the medical advice shift shouted “Dr. Huang, someone is looking for you” at the nurses’ station (because the haemodialysis room is an open ward, it is too svelte to hear, so we angels have developed a loud voice). I turned around and saw a short, frail middle-aged woman being pushed into the ward by her family in a wheelchair. I briefly understood the situation. The patient was from Xintian County, Yongzhou City, and had been on regular hemodialysis for more than 6 years. This time, she came to the clinic because of the formation of a mass on her right forearm, which was compressing the arteriovenous fistula (what we jokingly call the “lifeline” of uremic patients, which is the access to dialysis for uremic hemodialysis patients), resulting in the occlusion of the arteriovenous fistula, and she came to the clinic for the reconstruction of the arteriovenous fistula. According to the patient’s recollection, because this mass had been seen at several major hospitals, it was diagnosed as a tumor with a high possibility of malignancy and surgery was recommended, but the patient heard that the cost of surgery would be several tens of thousands of dollars (a large amount for uremic patients on dialysis for many years) and was told that the prognosis was not good, so he finally gave up surgery and continued dialysis to save his life. After I looked at the patient carefully and asked about the medical history in detail, I repeatedly asked myself, “Is this a tumor? Is it really a tumor?”. . With this question, I asked Director Guo Shenggen to check the patient personally. Director Guo instructed me to do some simple basic examinations for the patient: the X-ray report of the mass (right elbow joint) suggested that “the soft tissue of the right elbow joint is a mass of calcium density foci, and some of the bones overlap with the soft tissue calcium density shadow, which is not clear. Multiple vascular calcifications in the right upper extremity.” These reports gave us the answer: this is not a tumor. Not a tumor? Then what is this mass? It looks like a tumor, and the report is similar to a tumor. It is a complication of uremia, chronic kidney disease – bone mineral metabolism disorder (CKD-MBD), secondary hyperparathyroidism, ectopic calcification, which is a complication of uremia that can be misdiagnosed as malignant tumor. or even disappear. What is CKD-MBD, secondary hyperparathyroidism? It is a common systemic complication of uremia, with insidious clinical manifestations, and the target organs can be systemic organs, mainly affecting mineral metabolism, bone metabolism, vascular calcification, etc. It can be asymptomatic in the early stage, and often appears as “regressive man syndrome”, severe fractures and disabilities, body deformities, and multiple soft tissue masses throughout the body. The diagnosis is made only when the disease is formed. The disease is characterized by insidiousness, prevalence, systemic nature, disability, lethality, and low awareness rate. The clinical manifestations are complex and varied, mainly presenting as pruritus, restless leg syndrome, sleep disorders, bone pain, arthralgia, skeletal deformation, regressive man syndrome, calcification of blood vessels and soft tissues, calcification of heart vessels and valves, and local mass formation. Ancillary tests: Ultrasound of the parathyroid glands may reveal diffuse or nodular hyperplasia, or in severe cases, tumor-like hyperplasia; radiographs may show multiple vascular calcifications, periarticular or soft tissue calcified masses. The diagnosis of this disease requires a comprehensive judgment combined with medical history, clinical manifestations and auxiliary examinations. Treatment for this disease includes medication, surgical parathyroidectomy, and adequate blood purification therapy throughout. However, once skeletal malformations, vascular calcification, soft tissue calcification, regressed human syndrome, and parathyroid hormone >800 pg/mL that cannot be controlled by medication are present, parathyroidectomy is recommended as an early option. With active and effective treatment, the prognosis of this disease is good, and the patient’s quality of life can be significantly improved and enhanced. As a complication of uremia, the key to prevention and control of this disease lies in prevention, early diagnosis and treatment, and the root of uremia treatment lies in regular and adequate hemodialysis treatment, striving to reach 12 hours per week (the current domestic guideline standard is 12 hours of hemodialysis per week), regular hemodialysis dialysis patients should be routinely monitored for routine blood, blood calcium, blood phosphorus, alkaline phosphatase, parathyroid hormone, routine annual reexamination chest X-ray, and early intervention. In the past six months, our hemodialysis center has seen three patients with “soft tissue masses causing vascular access failure”, both of whom were misdiagnosed as malignant tumors in outside hospitals. Therefore, combining with our clinical experience, we suggest that patients with uremia who need to go to big hospitals for certain problems should try to go to nephrology or blood purification specialists first, because some diseases are rooted in kidneys but manifested in other organs, so it is up to our nephrologists to see the essence through the phenomenon to avoid misdiagnosis and omission.