Objective To compare the effect and safety on treatment of hyperphosphate-mia in hemodialysis patients with calcium acetate and calcium carbonate. Methods Sixty hemodialysis patients with hyperphosphatemia were treated with either calcium acetate or calcium carbonate for 8 weeks. The serum calcium, serum phosphate and parathyriod hormone (PTH) were detected before and after treatment and side effects of the treatment were recorded. Results The significant dropness of phosphorus levels were observed after 2 weeks treatment with calcium acetate and 4 weeks with calcium carbonate. The phosphorus levels significantly dropped in both groups after 8 weeks treatment ［(2.32±0.68)mmol/L vs (1.72±0.59)mmol/L, P<0.01 and (2.29±0.71)mmol/L vs (1.75±0.70)mmol/L, P<0.05, for calcium acetate and calcium carbonate, respectively］. The side effect rate of gastrointestinal symptoms in both calcium acetate group and calcium carbonate group were 23% and 27%( P>0.05), respectively, and hypercalcemia were 7% and 17%( P<0.01), respectively. There were no significant change in both groups in the PTH level. Conclusion Calcium acetate has the same effect on dedining of phosphorus level and happeming of gastrointestinal symptoms with calcium carbonate in treatment of hyperphosphatemia in hemodialysis patients. But the effect of phosphorus level dropness in calcium acetate group is faster than that in calcium carbonate group. And the hypercalcemia caused by calcium acetate treatment is lower than that by calcium carbonate treatment significantly. So, calcium acetate is an effective and safe salt for treating hyperphosphatemia in hemodialysis patients.