Objective To analyze the relationship between serum hepcidin level and bone mineral density (BMD) in patients with maintenance hemodialysis (MHD) and endstage renal failure (ESRD). Methods 40 patients with MHD and ESRD (MHD group), 32 patients with nondialysis of ESRD (nonMHD group) and 30 healthy examiners (control group) were selected. The levels of blood creatinine (Scr), blood phosphorus, blood calcium, C-reactive protein (CRP), parathyroid hormone (iPTH), hepcidin and BMD values of lumbar vertebra and femoral neck were measured. The differences of the above indicators were compared in each group, and the relationship between hepcidin and BMD was analyzed by Pearsoncorrelation analysis.Results Compared with control group, the levels of Scr, blood phosphorus, CRP, iPTH and hepcidin in MHD group and nonMHD group were increased while the level of blood calcium and BMD values of lumbar vertebra and femoral neck were decreased (P＜0.05). Compared with nonMHD group, the levels of Scr, blood phosphorus, CRP, iPTH and hepcidin in MHD group were increased while the level of blood calcium and BMD valuesof lumbar vertebrae and femoral neck were decreased (P＜0.05). Serum hepcidin in patients with MHD and ESRD was negatively correlated with blood calcium, lumbar vertebra BMD and femoral neck BMD, and was positively correlated with blood phosphorus, CRP and iPTH (P＜0.05). Conclusion MHD ESRD is characterized by high hepcidin, high Scr, high blood phosphorus, high CRP, high iPTH, low blood calcium and low BMD. The change of hepcidin level is closely related to iron and mineral metabolism and inflammatory response. It is positively correlated with blood phosphorus, CRP and iPTH and is negatively correlated with blood calcium, lumbar vertebra BMD and femoral neck BMD.