CKD renal patients have significantly reduced 1,25(OH)2D3 synthesis and lowered blood calcium due to destruction of effective renal units, malnutrition and insufficient vitamin D intake. These renal patients should be supplemented with vitamin D and calcium, but CKD renal patients at different stages have different needs for calcium and vitamin D. If they are blindly supplemented, they may or may not be able to get enough vitamin D and calcium. If supplementation is done blindly, the dose is either insufficient or can result in increased morbidity and mortality from cardiovascular complications due to ectopic calcification. Control of calcium? Adjust blood calcium in the target range: patients with CKD stages 3 and 4 should maintain blood calcium in the normal range, and patients with stage 5 should be maintained at the lower limit of normal levels i.e. 8.4-9.5 mg/dl (2.1-2.37 mmol/L) as far as possible. When is the best time to start calcium supplementation in CKD patients? Calcium and phosphorus metabolism and PTH levels should be assessed from the beginning of CKD stage 3, and supplementation should be initiated for those who do not meet the standard. For CKD patients with normal renal function who are still taking glucocorticosteroids, oral calcium carbonate or other calcium supplements (about 1g per day, and 1,25(OH)2D3 (Rogaine 0.25ug qd)) should be taken to promote its absorption. If CKD with renal insufficiency is combined with acid replacement and high phosphorus, it is better to take calcium carbonate (correcting acid and lowering phosphorus at the same time) and Rogaine (normalizing blood phosphorus as much as possible). CKD of renal failure, maintenance blood purification, the emergence of secondary hyperparathyroidism, renal bone disease in the service of calcium carbonate at the same time, rogaine shock, 1.0~2.0ug twice a week, pay attention to observe side effects. To avoid hypercalcemia,the total amount of elemental calcium intake (including dietary calcium and calcium-containing phosphorus binding agents) should not exceed 2000mg/day. Patients with normal or elevated calcium levels should preferably use calcium-free phosphate binders and a low-calcium dialysis solution (1.25 mmol/L). Food distribution of calcium? Calcium is found in almost all foods, but the calcium content varies widely. Dairy is the first food with high calcium content and good absorption, e.g. cow’s milk contains 120mg of calcium per 100mL. Eggs come next, with egg yolks being high in calcium. Vitamin D medication? On the basis of controlling blood phosphorus and adjusting blood calcium, activated vitamin D can be applied. activated vitamin D can promote calcium absorption, which in turn can calcify bone and maintain normal bones. Kidney patients with CKD stage 3-5 should mainly take oral supplementation of activated vitamin D. Intravenous activated vitamin D preparation can also be used in case of severe secondary hyperparathyroidism. How to supplement vitamin D? 1, when taking vitamin D, should avoid drinking porridge soup. Because porridge soup contains fat oxidase, can dissolve and destroy fat-soluble vitamins, so that vitamin AD and vitamin D loss. 2, plant foods almost do not contain vitamin D, vitamin D is mainly from animal foods. Vitamin D is mainly found in marine fish, animal liver, egg yolk and lean meat. In addition, skim milk, cod liver oil, cheese, nuts and seafood, and vitamin D fortified food, also contains rich vitamin D. 3, the source of vitamin D is slightly different from other nutrients, in addition to food sources, but also from their own synthetic manufacturing, but this needs to be more sun exposure, to receive more ultraviolet radiation. It is worth noting that vitamin D can not be oversupplemented, if overdose of vitamin D, will make the body too much vitamin D accumulation, symptoms of toxicity, such as loss of appetite, nausea and lethargy.