Objective To observe the correlation of fibroblast growth factor 23（FGF23）， Klotho protein and carotid artery intima media thickness（CIMT） in diabetic nephropathy（DN） patients， and discuss the effect of Tanshinone capsule on vascular calcification. Methods A total of 71 cases of patients with DN stage IV， were randomly divided into treatment group（36 cases）， control group（35 cases）. All patients were treated with basic treatment， and the treatment group was added with Tanshinone capsule， after 3 months， serum creatinine（Scr）， calcium（Ca）， phosphorus（P）， serum albumin（Alb）， total cholesterol（CHOL）， triglyceride（TG）， intact parathyroid hormone（iPTH）， serum FGF23， Klotho protein， TGF-β1， NF-κB， 24 hour urinary protein quantitative and CIMT were compared between the two groups， and selected 35 healthy volunteers as healthy control group. Results The treatment group had lower levels of CHOL、TG、serum TGF-β1、NF-κB、FGF23 and urinary protein quantitative， higher levels of Klotho protein， can inhibit CIMT thickening， the difference was statistically significant（P<0.05）. Spearman correlation coefficient showed that CIMT was positively correlated with urinary protein quantitative and FGF23 levels（P<0.05）， negatively correlated with Klotho protein（P<0.05）. Conclusion Tanshinone capsule can reduce CIMT and inhibit vascular calcification by regulating the FGF23-Klotho axis， may be associated with TGF-β1/NF-κB pathway.