Twenty-five elderly men receiving chronic hemodialysis had measurements of their bone mineral density (BMD) by dual-photon absorptiometry (DPA). Loss of BMD was much more pronounced in femoral necks than in lumbar vertebrae. Stepwise multiple liner-regression analysis showed that low BMD was associated with 1) hypoalbuminemia, hypermagnesemia, hyperaluminemia, and high serum alkaline phosphatase for femoral necks and 2) hypercalcemia and hypermagnesemia for lumbar vertebrae. These observations suggest that the femoral neck is the preferred site for measurement of BMD in dialysis patients. Along with factors directly affecting bone metabolism, nutritional factors may affect BMD in such patients.