The aim of this study was to evaluate status of bone metabolism in patients on chronic maintenance dialysis, to elucidate dominant mechanisms in the genesis of renal osteodistrophy (ROD) with simultaneous measuring of biochemical regulators and parameters of bone metabolism and scintigraphic study of metabolic activity of the skeleton. We found that disturbance of skeletal homeostasis existed in all patients, dominant hyperparathyroid bone disease was found in most of them, mixed uremic osteodistrophy (hyperparathyroidism and vitamin D deficiency) was observed in less percent, i.e. only in 6% renal bone disease with low turnover due to osteomalacia or adynamic bone disease was present. Simultaneous determinations of most relevant factors of bone metabolism and scintiscan discover changes in skeletal homeostasis, and can prevent severe disturbances and treat adequately those ones which already exist.