It is unclear whether any significant changes in the epidemiology of chronic kidney disease (CKD), possibly resulting from the exceedingly rapid economic development and the aggressive prevention and treatment of kidney diseases in the Chinese population, have occurred over the past two decades. The medical records of 173 CKD patients from 1990-1991 and 956 patients from 2009-2010 were retrospectively analyzed. In patients from 1990-1991, CKD occurred at an earlier age, with severely decreased kidney function. On average, these patients progressed to end-stage renal disease 4.5 years faster. Diabetes and hypertension have become the most common causes of CKD in elderly patients in 2009-2010 period, representing 39.5 % and 24.2 % of all CKD causes, respectively. In the 1990-1991 period, CKD was characterized by a high frequency of severe anemia in stage 4 and 5 patients. The mean arterial pressure in patients with CKD stage 4 and stage 5 decreased significantly in. Although the number of dyslipidemia patients in stage 4 and 5 was significantly higher in the 2009-2010 period, there were no substantial differences in the average levels of serum triglycerides and total cholesterol in the two cohorts. Hypoproteinemia also became less common than before. The occurrence of cardiovascular events was significantly reduced in stage 4 and stage 5 patients in 2009-2010. Diabetes and hypertension have increased and become the leading causes of CKD in elderly Chinese patients. Improvement in the control of CKD complications has been significant, mainly regarding anemia, hypertension, dyslipidemia, and hypoproteinemia.