Renal osteodystrophy, a well-established chronic complication of dialysis patients and also a surrogate for quality of renal replacement therapy, is classified into high-turnover and low-turnover rate bone diseases. The former is mainly caused by secondary hyperparathyroidism, whereas the latter consists of aluminum intoxication and adynamic bone disease. According to the pathophysiology of renal osteodystrophy, manipulation of serum calcium and phosphate is critical for the management of dialysis patients to prevent and control this complication. The goal of management of renal osteodystrophy is not only to get good control of hyperparathyroidism, but also to avoid low-turnover rate bone diseases.