【Abstract】 Objective To understand the bone metabolism, the controlling situation of the bony disease, and their related factors in maintenance hemodialysis (MHD) patients. Methods We investigated renal bone disease in 113 MHD patients in the Hemodialysis Center of the Affiliated Hospital of Qingdao University Medical College, and compared these data with the guidelines of bone metabolism and controlling of bony disease in Kidney Disease Outcome Quality Initiative (K/DOQI) recommended by National Kidney Foundation of the United States. We also analyzed age, gender, Kt/V, body mass index (BMI), years for dialysis, renal function, blood pressure, Hb, and high sensitivity C-reactive protein (hs-CRP) in these patients. Results In the 113 cases, normal serum Ca was found in 61 (54.0%) cases, normal phosphate in 45 (39.8%) cases, normal Ca x P product in 72 (63.7%) cases, and normal iPTH in 35 (31.0%) cases. However, normal values of the above 4 parameters recommended by K/DOQI were only found in 20 (17.7%) cases. Single and multiple variable regression analyses showed that renal osteodystrophy did not correlate with gender, age, hs-CRP, Kt/V, and years for dialysis. However, higher serum creatinine, lower Hb, lower BMI, and blood pressure ≥140/90mm Hg (1mm Hg=0.133 kPa) were the risk factors for renal osteodystrophy. Among these risk factors, higher serum creatinine, lower Hb and hypertension were the independent risk factors. Conclusion The bone metabolism and the control of the bony disease could not conform to the standards in the K/DOQI guidelines in most hemodialytic patients. The presence of renal osteodystrophy closely relates to higher serum creatinine, lower Hb and hypertension