〔Abstract〕 Objective To explore the occurrence and related factors of liver fibrosis in patients with End-stage renal disease(ESRD). Methods A total of 83 ESRD patients were included in the study. Transient elastography was used to diagnose whether hepatic fibrosis occurred or not. According to the occurrence of hepatic fibrosis or not, the included patients were divided into a non-hepatic fibrosis group(n=37) and a hepatic fibrosis group(n=46). The demographic data and clinical laboratory indexes of the two groups were compared. Statistically significant variables were selected and included in the multivariate Logistics stepwise regression analysis to explore the influencing factors of liver fibrosis in ESRD patients. Results The prevalence of liver fibrosis in ESRD patients was 55.42%. Compared with the non-hepatic fibrosis group, the hepatic fibrosis group had lower white blood cells, erythrocyte sedimentation rate, complement C3 and C4(P<0.05). Multivariate Logistics analysis showed that complement C4 level(OR=0.930, 95%CI: 0.872-0.992,P=0.028) and higher lactate dehydrogenase(LDH) level(OR=1.016, 95%CI: 1.005-1.027,P=0.004) were the independent influencing factors of liver fibrosis in ESRD patients. Conclusion The probability of liver fibrosis in ESRD patients is high. Serum complement C4 and LDH are independent influencing factors of liver fibrosis. Dynamic monitoring of serum complement C4 and LDH levels is conducive to target liver fibrosis in ESRD patients.