Paricalcitol, a new Vit. D analogue is thought to be more potent than Calcitriol and has also been reported to cause less hypercalcemia. We report one‐year follow‐up on patients (N = 74) from one inner city dialysis unit. Patients were stratified in groups A, B, C, D depending on intact Paratharmone (iPTH) levels i.e., < 100, 100–300, 300–600, > 600 respectively. Serum Ca, PO4, alkaline phosphatase (ALK), albumin (ALB), hemoglobin (Hb) was measured monthly and serum iPTH was checked quarterly. The results are as follows: Group # PTH Ca PO4 ZPR Hb EPO pg/dl mg/dl mg/dl mcg/hd g/dl U/kg/hd A656.83*9.745.32011.72255.8†B22197.01**9.045.532.48¶12.12137.55C29422.89**9.45.734.54¶¶11.86128.87D171253.4**9.887.2112.51¶¶12.174.35†† PTH: p < 0.05 = *vs**, ZPR(zemplar): p < 0.05¶ vs¶¶, mcg: microgram EPO(erythropoietin): p < 0.05 = † vs††, Mean age, weight, URR, ALB., ALK. and iron indices were not statistically different in all groups. Mean duration of hemodialysis (HD) was 34, 30, 57 & 65 months in groups A, B, C, D respectively. None of these patients had symptomatic bone disease. Seven patients were changed to low Ca (1.0 meq/L) bath secondary to hypercalcemia (Ca > 11.5) & severe hyperparathyroidism (HPT). This data suggest that severe HPT is frequent despite aggressive Paricalcitol therapy in the inner city HD population. More effective noncalcium phosphate binders and/or calcimimetic agents may be needed in addition to dietary and medication compliance in group D to control severe HPT. Interestingly patients with low PTH (< 100) showed relative epogen resistance while patients in group D required smaller epogen doses. There was inverse relationship between ZPR & EPO dosage. The effect of ZPR on EPO responsiveness needs to be confirmed in larger study.