Objective To measure the changes of serum fractalkine (FKN) and tissue inhibitors of metalloproteinase-1 (TIMP-1) in maintenance hemodialysis (MHD) patients, and to discuss the relationship between inflammation and serum concentrations of FKN and TIMP-1. Methods We measured serum FKN and TIMP-1 by ELISA before and after hemodialysis in 30 MHD patients. Their serum high-sensitivity C-reactive protein (Hs-CRP) before hemodialysis was measured by immunonephelometry. Serum albumin (ALB), hemoglobin (HB), body mass index (BMI) and the dialysis adequacy marker Kt/V were also determined. BUN and serum creatinine (Scr) were assayed before and after hemodialysis. Results Serum FKN and TIMP-1 increased after hemodialysis (P<0.01, as compared with their respective values before hemodialysis). Before hemodialysis, their serum FKN and Hs-CRP were positively correlated (r=0.387, P<0.05), but their serum FKN did not correlated to serum TIMP-1 or to hemodialysis duration (P>0.05), nor did their serum TIMP-1 to Hs-CRP or to dialysis duration (P>0.05). The differences of serum FKN concentrations before and after hemodialysis were positively correlated to Hs-CRP (r= 0.291, P<0.05), but had no correlation with the differences of serum TIMP-1 concentrations before and after hemodialysis or to dialysis duration (P>0.05). The differences of serum TIMP-1 concentrations before and after hemodialysis were also positively correlated to Hs-CRP (r=0.226, P<0.05), and had no correlation with dialysis duration (P>0.05). Conclusion Serum FKN and TIMP-1 increase after hemodialysis in MHD patients. The instantaneous changes of serum FKN and TIMP-1 after hemodialysis may relate to the microinflammatory state.