Abstract: 【Abstract】Objective To investigate the difference expression of Klotho in parathyroid cells with nodular hyperplasia and diffuse hyperplasia from Secondary Hyperparathyroidism(SHPT) patients. Method A total of 50 SHPT patients and 8 cadaver were selected were selected and accepted parathyroidectomy. SHPT patients were divided into diffusible hyperplasia group and nodular hyperplasia group according to pathology. Serum fibroblast growth factor-23(FGF-23) and parathyroid hormone(PTH) were detected. The expression of Klotho and Ki67 in different hyperplasia parathyroid cells were detected by immunohistochemistry. Results (1)In SHPT patients, serum FGF-23 was positively correlated with PTH（r=0.438，P=0.001）; (2)Serum FGF-23 was negatively correlated with the expression of Klotho in parathyroid cells（r=-0.379，P=0.007）; serum PTH was negatively correlated with the expression of Klotho in parathyroid cells（r=-0.361，P=0.01）; (3) Compared with control group, the expression of Ki67 in SHPT group was increased significantly（F=54.417，P=0.000）, and the expression of Klotho decreased significantly（F=49.243，P=0.000）. Compared with diffusible hyperplasia group, the expression of Ki67 in nodular hyperplasia increased significantly（t=3.760，P=0.001）, the expression of Klotho decreased significantly（t=6.039，P=0.000）. Conclusion Klotho may contributed to different hyperplasia of parathyroid cells in SHPT patients

Key words: Secondary Hyperparathyroidism, Fibroblast growth factor-23, Klotho