Objective To investigate the effect of hemodialysis on the plasma tissue factor (TF) and tissue factor pathway inhibitor (TFPI) activity in maintenance hemodialysis (MHD) patients. Methods　 The plasma activity of TF and TFPI was measured by chromogenic assay in 20 non-dialyzed end-stage renal disease (ESRD)patients, 23 MHD subjects and 23 normal controls. Results ①The plasma TF activity in non-dialyzed ESRD patients and MHD ones was higher than that in normal controls (1.1790±0.2937) nm vs. (0.3055±0.1901) nm；(0.8848±0.5461) nm vs.(0.3055±0.1901)nm，respectively, (P<0.01). However compared with the MHD patients, the plasma TF activity in non-dialyzed ESRD patients was even higher but without significance (P>0.05)； ②The plasma TFPI activity in ESRD ones was higher than that of the normal controls (P>0.05). The plasma TFPI activity in MHD patients was higher than that in non-dialyzed patients, but there was no statistical significance； ③The plasma TFPI activity increased after a hemodialysis session (2.1105±1.3637) u/ml vs. (1.3347 ± 0.8419)u/ml, ( P<0.05). The plasma TF activity post-hemodialysis decreased in comparis on with pre-HD (0.6816±0.3798)nm vs. (0.8848±0.5461) nm, ( P = 0.071)； ④ The difference of TFPI was linear correlated with the dosage of heparin used during a hemodialysis session (R2＝0.190， P<0.05). ⑤ The difference of TF activity was linear correlated with the TFPI activity (r=-0.263, P<0.05). Conclusion In the ESRD patients, the plasma TF activity raised to a high level, but the TFPI activity increased lighly. However, contrasted to the non-dialyzed patients, the plasma TF activity reduced while the plasma TFPI activity increased in the MHD subjects, which became more significant after hemodialysis. The difference of the TFPI activity between pre-HD and post-HD was positively linear correlated with the dosage of the heparin used in a hemodialysis session. It suggested that the extrinsic coagulation pathway dysfunction might play an important role in the deterioration of renal function. Some factors (e.g.heparin) in HD session may have effect on reversing the haemostatic abnormalities. 