To study the characteristics of TCM syndrome elements in patients with maintenance hemodialysis (MHD) during chronic kidney disease stage 5 (CKD5).Methods:By epidemiological methods,a total of 286 MHD patients from a multi-center survey from January 2019 to May 2019 were selected as the research objects to collect general information and TCM symptom information.At the same time,tongue image information was collected by tongue imager.Factor analysis was used to statistically analyze the symptoms and tongue image data.The meaning of the common factor of TCM syndrome was summarized according to the theory of traditional Chinese medicine.Results:A total of 12 common factors were extracted.The disease location elements included the kidney,the spleen,the liver,the heart and the stomach.The kidney,the spleen and the liver were the main factors.The syndrome elements of the disease nature were qi deficiency,yin deficiency and yang deficiency,in which the main factors were the qi deficiency and yin deficiency.The syndrome elements of pathogenic factors were dampness,heat,blood stasis,stiring wind,with dampness,heat,blood stasis as the main elements.Conclusion:MHD patients in CKD5 5 stage was deficient in origin and excessive in superficiality.The origin deficiency includes spleen-kidney qi deficiency,spleen-kidney yang deficiency,liver-kidney yin deficiency and qi-yin deficiency.While excessive superficiality includes kidney collateral blood stasis-heat,dampness-heat of liver and gallbladder,intermingled deficiency and excess includes spleen deficiency due to dampness and turbidity,kidney deficiency due to dampness and heat,blood stasis due to qi deficiency and stirring wind due to yin deficiency.