Objective To study the expressions of fibroblast growth factor receptor-1 ( FGFR1)and Klotho in the development of secondary hyperparathyroidism( SHPT) in chronic renal failure and their clinical significance. Methods 30 patients with SHPT were recruited to SHPT group. Six organ donors without renal disease were assigned to be normal group. All the subjects underwent detection of serum FGF23 and iPTH by ELISA and chemiluminescence enzyme immunoassay. The parathyroid glands were operated from normal and SHPT groups, and then the expression of FGFR1and Klotho in parathyroid gland tissue were detected by Immunohistochemistry. Absorbance was calculated. Results ( 1) Levels of serum FGF-23 and PTH of SHPT patients were increased significantly compared with control group( P<0.05). Serum FGF-23 was positively correlated with serum PTH in SHPT patients( P<0.05).( 2) The expression of FGFR1 and Klotho in the parathyroid glands with nodular hyperplasia and diffuse hyperplasia in SHPT group were all downregulated significantly compared with normal group( P<0.05). Conclusions The significant downregulation of FGFR1 and Klotho in parathyroid glands with nodular hyperplasia and diffuse hyperplasia of SHPT patients compared with normal group in parathyroid tissue maybe the main mechanism of SHPT.