Objective: To investigate the clinical effect of combined application of calcitriol and low-calcium dialysate in the treatment of secondary hyperparathyroidism (SHPT). Methods: Eighty-nine patients with SHPT who visited the hospital from February 2023 to February 2025 were included in the study. They were divided into an observation group (n=45) and a control group (n=44) using a random number table method. The observation group received calcitriol combined with low-calcium dialysate treatment, while the control group received calcitriol combined with conventional dialysate treatment. The differences in intact parathyroid hormone (iPTH), calcium and phosphorus metabolism indicators, renal function indicators, and adverse reaction rates were compared and evaluated before and after treatment between the two groups. Results: Compared with before treatment, the levels of iPTH, serum phosphorus, and calcium-phosphorus product were significantly reduced in both groups after treatment, and the observation group had lower levels than the control group (P < 0.05). Additionally, the blood calcium levels in both groups increased compared to before treatment, and the observation group had higher levels than the control group (P < 0.05). After intervention, there was no statistically significant difference in renal function indicators between the two groups (P > 0.05). The incidence of adverse reactions in the observation group was lower than that in the control group (P < 0.05). Conclusion: The combination of calcitriol and low-calcium dialysate for the treatment of SHPT can effectively reduce the levels of iPTH, serum phosphorus, and calcium-phosphorus product, increase blood calcium levels, and has a low incidence of adverse reactions. It has no significant effect on renal function and is a safe and effective treatment method.