Chronic renal failure--> decreased clearance of phosphate --> hyperphosphatemia --> decreased production of activated vitamin D (1,25 dihydroxy) --> hypocalcemia --> hyperparathyroidism --> hypercalcemia, renal osteodystrophy

hyperphosphatemia --> vascular calcifications --> calciphylaxis (necrotic skin lesions)

Men:  decreased testosterone
Women: amenorrhea, infertility, hyperprolactinemia

Pruritis