Introduction: To investigate associations between diabetic retinopathy (DR) and chronic kidney disease (CKD) in patients with type 2 diabetes (DT2). Methods: The participants of the cross-sectional, community-based Tongren Health Care Study underwent a detailed medical and ophthalmological examination. We defined DT2 by a fasting plasma glucose concentration of >= 7.0 mmol/L or a medical history. CKD was classified as either reduced estimated glomerular filtration rate (eGFR) of <60ml/min/1.73mm(2), or presence of albuminuria. DR was assessed using color fundus photographs. Results: Out of 62,217 participants of the Tongren Health Care Study, 5103 (8.2%) patients had DT2. The prevalence of DR was 12.8% (95%CI, 11.8%, 13.7%), CKD was 13.3% (95%CI,12.4%, 14.3%), and the subtypes of CKD, including reduced eGFR and albuminuria was 4.6% (95%CI, 4.2%, 5.1%), and 10.1% (95%CI, 9.3%, 10.9%), respectively. DR was detectable in 21.0% of the patients with CKD, while CKD present in 20.9% of the DR patients. Higher DR prevalence was associated with higher prevalence of albuminuria and reduced eGFR (both P<0.05). Factors independently associated with the presence of CKD instead of DR were older age (P<0.001, OR=1.05), a higher body mass index (P<0.001, OR=1.14), a higher serum concentration of triglycerides (P<0.001, OR=1.26), and a lower blood glucose (P<0.001, OR=0.93). Having hypertension was additionally associated with the presence of reduced eGFR as compared with DR (P=0.005, OR=4.47). Conclusions: TD2 patients of older age and with higher body mass index, hypertension and dyslipidemia had a higher probability of being affected by CKD rather than DR, while those with a higher blood glucose level were more prone to DR than CKD.