Objective:To evaluate the correlation between serum leptin with clinical and blood biochemical indexes,and longitudinal changes of above parameters after parathyroidectomy (PTX) in stage 5 chronic kidney disease(CKD) patients. Methods:This cross－sectional study not only included 113 stage 5 CKD patients together with 76 healthy controls but also contained a follow－up of two subgroups classified as successful (n = 23) and unsuccessful (n = 4) PTX. Clinical characteristics,blood biochemistry and serum leptin levels were measured. Results:Serum leptin concentration was positively correlated with age and body mass index (BMI),but negatively correlated with serum albumin (Alb) level in healthy men. In healthy women,serum leptin concentration was positively correlated with BMI. There was no significant difference of serum leptin between healthy controls and stage 5 CKD patients. Serum leptin concentration in patients with stage 5 CKD was correlated positively with BMI,serum glucose,serum triglyceride (TG) and serum Alb in males and BMI,hemoglobin (Hb),hematocrit (Hct) and serum TG in females. However,serum leptin had a negative relationship with serum high density lipoprotein (HDL) and serum intact parathyroid hormone (iPTH) in males and only serum HDL in females. Compared with baseline,the successful PTX subgroup had significant improvement in serum leptin level. Increased serum leptin change was positively related to increased weight,Hb and Hct change as well as decreased lgiPTH change in this group. There was no improvement in the above parameters in the unsuccessful PTX group. Conclusion:Serum leptin level has no significant difference between stage 5 CKD patients and health subjects. However,it is associated with bone－mineral metabolism,hematopoiesis and nutritional indexes in stage 5 CKD patients. Successful PTX contributes to increased serum leptin level and improved nutrition,anemia and bone－mineral metabolism..