Objective：To evaluate the abnormalities of bone metabolism in renal transplant recipients and chronic kidney disease patients undergoing stage 5 dialysis，and to explore the changes of bone metabolism after renal transplantation. Methods：Retrospective analysis was performed on 156 recipients who were hospitalized for follow-up review in the First Affiliated Hospital of Nanjing Medical University from January 2017 to June 2018. All recipients had received kidney transplantation for six months or more. Total 77 dialysis patients hospitalized from January to May 2018 were simultaneously included. Serum calcium（Ca），phosphorus（P），25-hydroxy vitamin D［25（OH）D］，parathyroid hormone（PTH），bone-specific alkaline phosphatase（bALP），osteocalcin（OC），type I collagen cross-linked N-terminal peptide（NTx），type I collagen cross-linked C-terminal peptide（CTx），tartrate-resistant acid phosphatase 5b（TRAP-5b），and bone mineral density（BMD）were compared between the two groups to investigate changes of bone metabolism after kidney transplantation. Results：The mean age of 156 kidney transplant recipients was （39.9 ± 9.5） years old，and 65.4% were male. The mean age of 77 dialysis patients was （38.2 ± 10.2） years old，and 71.4% were male. The incidence of abnormal bone metabolism markers in renal transplantation group vs. dialysis group：Low correction Ca was 0.0% vs. 9.5%，high correction Ca was 14.8% vs. 9.5%，low P 25.0% vs. 2.6%，high P 3.2% vs. 85.5%，high PTH 51.4% vs. 85.9%，low 25（OH）D 63.7% vs. 81.9%，high OC 17.8% vs. 98.6%，high NTx 84.6% vs. 100.0%，high CTx 80.8% vs. 100.0%，high TRAP-5b 18.2% vs. 46.5%. There were significant differences in those markers between the two groups（P < 0.05）. There was no difference in bALP between two groups（P > 0.05）. The incidence of right femur neck osteopenia and osteoporosis was 19.0% and 3.6% in the kidney transplantation group，respectively，and was 17.7% and 4.8% in the dialysis group，respectively. The incidence of lumbar spine osteopenia and osteoporosis was 26.5% and 4.4% in the kidney transplantation group，respectively，and was 19.4% and 4.8% in the dialysis group，respectively. Both showed no differences between two groups（P > 0.05）. The influence factors of BMD were preoperative history of parathyroidectomy，body mass index（BMI），total cholesterol（TC），normal blood phosphorus levels and neutrophils（NE）（P < 0.05）in the kidney transplantation group. While，age and PTH were influence factors of BMD in the dialysis group. Conclusion：This study showed that the indicators of bone metabolism abnormalities could be improved after kidney transplantation，but under the condition of stable renal function，some patients still showed persistent bone metabolism abnormalities. It is helpful to evaluate mineral and bone metabolism abnormalities after kidney transplantation by synthesizing changes and trends of bone metabolism indexes.