Chronic kidney disease (CKD) has been a global public health issue in the past decades and affects more than 10% population worldwide. But there are still limited studies to explore the epidemiological features of CKD in China. From July 2016 to June 2018, a total of 29100 participants were randomly enrolled from 3 urban communities and 4 rural districts of Henan province. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 mL/min.1.73m2 or urinary albumin to creatinine ratio ≥ 30 mg/g (albuminuria). Diabetic subjects with systolic blood pressure > 140mmHg, albuminuria or an eGFR less than 60 mL/min/1.73 m2 were classified as having DKD. Participants completed a questionnaire assessing lifestyle and relevant medical history, and blood and urine specimens were taken. Serum creatinine, uric acid, total cholesterol, triglycerides, low-density lipoprotein, high-density lipoprotein and urinary albumin were assessed. The age- and sex-adjusted prevalences of CKD and DKD were calculated, and risk factors associated with the presence of reduced eGFR, albuminuria, DKD, severity of albuminuria and progression of reduced renal function were analyzed by binary and ordinal logistic regression. A two-sample mendelian randomization (MR) analysis was employed to calculate the causal effects between risk factors and CKD. The exposure included alcohol consumption, physical activities, BMI, diabetes, hypertension and dyslipidemia, the outcome was eGFR < 60 and albuminuria, respectively. There were 23869 rural participants were recruited. Totally, 4347 participants were suffering from CKD, in which 962 subjects were DKD patients.The overall adjusted prevalence of CKD was 16.4% (15.9–16.8%) and that of DKD was 2.9% (2.7–3.1%). In all participants with diabetes,the prevalence of reduced eGFR was 6.3% and that of albuminuria was 45.3%. The overall prevalence of CKD in participants with diabetes was 48.0% (95% CI = 43.1–52.9%). A total of 5231 urban participants were recruited. The overall adjusted prevalence of CKD was 16.8% (15.8–17.8%) and that of DKD was 3.5% (3.0–4.0%). Decreased renal function was detected in 132 participants (2.9%), whereas albuminuria was found in 858 participants (14.9%). In all participants with diabetes,the prevalence of reduced eGFR was 6.3% and that of albuminuria was 45.3%. The overall prevalence of CKD in participants with diabetes was 48.0%. Results of the binary and ordinal logistic regression indicated that the factors independently associated with a higher risk of reduced eGFR and albuminuria were older age, male gender, smoking, alcohol consumption, overweight,obesity, diabetes, hypertension, dyslipidemia and hyperuricemia. MR analysis showed that increased BMI and hypertension had casual effects on development of eGFR < 60 (β = 0.15 and 1.38) and albuminuria (β = 0.08 and 0.46). The results of our current study demonstrate that the prevalences of CKD and DKD are still high in Chinese rural and urban population and they are going to be a major social-economic burden in China. High prevalent hypertension and diabetes are primary risk factors for them. Increased BMI and hypertension have causal effects on development of CKD. Specific strategies and interventions aimed at reducingthe burden of CKD and DKD are urgently needed.