Background: China is undergoing a rapid transition to an urbanized and Western diet pattern, which worsens the public health burden of metabolic syndrome (MS) and chronic kidney disease (CKD). We aimed to estimate the prevalence of CKD among adults with MS and to evaluate the association between MS and CKD in China. Methods: The data were obtained from the China National Diabetes and Metabolic Disorders Study conducted from June 2007 to May 2008.A total of 15,987 individuals aged 20 y or older were included as study participants. Results: Age-standardized prevalence of CKD, which was defined as a glomerular filtration rate <60 ml/min/1.73 m(2), in participants with and without MS was 4.64% and 3.30%, respectively. The multivariate-adjusted odds ratio of CKD associated with MS was 1.495 (95% Cl: 1.190-1.879). Elevated blood pressure, elevated fasting glucose, elevated triglycerides, and reduced high-density lipoprotein cholesterol had statistically significant increased odds ratios of 1.218, 1.256, 1.325 and 1.797 for CKD, respectively, while elevated waist circumference was not significantly associated with an increased odds ratio of CKD. Conclusions: Our study suggests an increasing prevalence of CKD among Chinese adults with MS and a strong association between CKD and MS. (C) 2014 The Authors. Published by Elsevier B.V. All rights reserved.