Abstract: Objective　To explore the changes of bone metabolism in children with newly diagnosed primary nephrotic syndrome (PNS). Methods　Forty-five children diagnosed with PNS from February 2013 to July 2016 were selected into the PNS group, and 30 healthy children in the same period were enrolled in the control group. The serum calcium, phosphorus, bone alkaline phosphatase (BALP), osteocalcin (BGP), type I collagen cross linked C terminal peptide (CTx) and serum tartrate resistant acid phosphatase 5b (TRACP), and 25-(OH)D were measured and compared between two groups. Bone mineral density (BMD) was measured by ultrasound. Results　The levels of BALP, CTx, and 25-(OH)D in the PNS group were higher than those in the control group, and the levels of BGP, TRACP, blood calcium, and BMD (Z- scores) in the PNS group were lower than those in the control group, and the differences were statistically significant (P<0.01). There was no significant difference in serum phosphorus between two groups (P>0.05). Conclusions　Abnormal bone metabolism is found in children with newly diagnosed PNS and its manifestations include calcium loss, reduced bone formation, and increased bone resorption.