The total body bone mineral density (BMD) in Japanese hemodialysis (HD) patients was compared with that of healthy subjects, in terms of BMD characteristics by sex, age and dialysis history. The subjects were 346 patients receiving HD treatment at the Narita Memorial Hospital Dialysis Center (209 males, 137 females). The controls were 1385 healthy subjects. For total-body BMD measurement, dual energy X-ray absorptiometry (DXA) was used, along with a Lunar DPX bone densitometer. BMD levels in both male and female HD patients were lower than those of normal subjects in their 30s to 50s. Males, in particular, showed a marked decrease in BMD in their 30s, 40s and 50s, while females did so in their 40s, 50s and 60s (both p<0.001). There was no significant difference, however, between either male or female HD patients and normal subjects in terms of BMD in their 70s. No significant difference was recognized in BMD levels between male HD patients with a dialysis history of less than 3 years and the normal subjects, both ranging from 50 to 70 years of age. Thus, we considered BMD to have decreased minimally during conservative therapy in male chronic renal failure patients. However, BMD levels in females in their 40s to 60s with a history of less than 3 years of HD, showed a significant decrease as compared to normal subjects (p<0.01). Using multiple regression analysis, body weight loss was found to be one of the major risk factors for BMD loss. In conclusion, BMD differences were found to exist in HD patients in terms of sex, age and dialysis history.