Abstract： Objective:To investigate the prevalence and risk factors of chronic kidney disease (CKD) in diabetic patients aged over 40 years in Henan province.Methods:A cross-sectional study was conducted. Diabetic patients aged over 40 years were recruited from four cities including Xuchang, Zhumadian, Luoyang and Zhengzhou in Henan Province between June 2015 and July 2019. Multivariate logistic regression analysis was employed to analyze the risk factors for CKD.Results:A total of 3 067 diabetic patients were included in this study, including 1 238 males and 1 829 females. The mean age of all participants was (60.9±9.7) years and 85.8% (2 633/3 067) of them were living in rural areas. There were 1 155 participants who had CKD, and the overall prevalence of CKD was 37.7% (95% CI: 35.9%-39.4%). Compared with those without CKD, participants with CKD had older age [(61.4±10.3) vs (60.6±9.3) years], higher proportion of male patients (43.2% vs 38.7%), urban residents (19.4% vs 11.0%) and habitual drinkers (15.8% vs 12.7%), higher body mass index [(25.8±3.7) vs (25.4±3.6) kg/m 2), higher proportion of having hypertension (57.0% vs 37.2%), hyperuricemia (10.7% vs 7.1%) and dyslipidemia (46.5% vs 42.7%) (all P<0.05). The prevalence of estimated glomerular filtration rate (eGFR) less than 60 ml·min -1·(1.73 m 2) -1 and albuminuria was 4.9% (149/3 067) and 35.6% (1 092/3 067), respectively. Compared with rural participants [35.4% (95% CI: 34.4%-36.4%)], urban participants [51.6% (95% CI: 50.0%-53.2%)] had higher prevalence of CKD ( P<0.001). Multivariate logistic regression analysis showed that habitual drinker ( OR=1.27, 95%CI: 1.00-1.61, P=0.046), moderate physical activities ( OR=1.23, 95%CI: 1.01-1.51, P=0.039), having hypertension ( OR=2.27, 95%CI: 1.95-2.64, P<0.001), dyslipidemia ( OR=1.21, 95%CI: 1.04-1.40, P=0.012) and hyperuricemia ( OR=1.56, 95%CI: 1.21-2.02, P=0.001) were independent risk factors for CKD. Conclusions:The prevalence of CKD is high in diabetic patients who aged over 40 years in Henan province. The associated factors for developing CKD include habitual drinking, heavier physical activities and having chronic diseases. Targeted prevention and intervention for associated factors would be beneficial for controlling CKD in middle and old aged diabetic patients.