One of the differences of bone X-ray findings with long-term hemodialysis patients in 1978 and 1991, is a frequency of subperiosteal bone resorption. High incidence of periosteal bone resorption is found in 1978 but in 1991, it is low. In 1978 we did not administer active vitamin D but in 1991 it has already administered for ten years. Administration of active vitamin D is available for the prevalence of periosteal bone resorption but active vitamin D therapy to suppress the secondary hyperparathyroidism occasionally fails in advanced cases and hypercalcemia is found. Intermittent and pharmacologically high levels of plasma calcitriol are reported to suppress the PTH secretion effectively and recently 22-oxacalcitriol, a new active vitamin D analogue, is found to suppress PTH secretion without increasing plasma calcium. It is thought to be a more suitable therapy of secondary hyperparathyroidism.