To compare the efficacy of oral calcitriol and oral alfacalcidol for the treatment of secondary hyperparathyroidism in children on PD.   Retrospective study on 26 pediatric patients divided  into two groups:  oral alfacalcidol (n=21) and oral calcitriol (n=5). The following characteristics were analyzed: parathyroid hormone (PTH), total plasma calcium, ionized plasma calcium, plasma phosphorus before treatment, 3 and 6 months after, initial dose and corrected dose of active vitamin D after 3 months. Independent t-test and repeated measures Anova were used for comparison between alfacalcidol and calcitriol groups. The second step was to compare the efficacy of calcitriol in subgroup of patients from alfacalcidol group who were switched to calcitriol later (n=12). To compare data in subgroup between baseline and 3 months after conversion from alfacalcidol to calcitriol we used paired t-test. After 6 months, there was significant decrease of PTH level  261±259 pmol/L compared with alfacalcidol group 1080±716 pmol/L (P=0.047) and increase in total calcium in calcitriol group 2.46±0.17 mmol/L compared with alfacalcidol group 2.09±0.25mmol/L (P=0.035). The mean dose of calcitriol was also significantly lower as opposed to alfacalcidol dose: 0.04±0.039 µg/kg/week and 0.17±0.076 µg/kg/week respectively (P=0.002) (Table 1). The mean age of children who were switched from alfacalcidol to calcitriol were significantly different comparing with those who continued alfacalcidol (5±4.6 and 10±4.3 years of age respectively (P=0.022)). 3 months after conversion there was significant increase in ionized calcium level and decrease in PTH level comparing with baseline (Table 2). The dose of alfacalcidol before and dose of calcitriol after switch were differed (0.18±0.1 µg/kg/week and 0.13±0.05 µg/kg/week respectively, P=0.025) Calcitriol showed superior efficacy for the treatment of secondary hyperparathyroidism in children on PD with the dose 4.25 times lower that of alfacalcidol.  Alfacalcidol had limited efficacy for the treatment of secondary hyperparathyroidism in children when prescribed in recommended doses.