Impairment of renal function causes various abnormalities of bone mineral metabolism including secondary hyperparathyroidism. The Japanese Society of Dialysis Therapy proposed the guidelines for the treatment of secondary hyperparathyroidism in chronic dialysis patients (JSDT guidelines) in 2006. From the perspective of better survival rate, the control goal value was determined to be 3.5-6 mg/dl for phosphorus, 8.4-10.0 mg/dl for calcium, and 60-180 pg/ml for intact PTH levels. When the 3 items cannot be controlled by treatment with an active vitamin D preparation, treatment is considered to be a failure, and intervention treatment of the parathyroid gland is recommended. The adequacy of the JSDT guideline must be evaluated by its clinical application.