Chronic kidney disease (CKD) is a new cardiovascular disease risk factor. However, few epidemiological studies examined the relationship between CKD and the risk of developing cardiovascular disease (CVD) in a general population. We evaluated the significance of CKD on the incidence of CVD by using a large community-based mass screening registries in Okinawa, Japan. Screenees of the 1983 Okinawa General Health Maintenance Association were investigated whether they also registered in the hospital-based stroke and acute myocardial infarction registry and the dialysis program. All relative risks of CVD and dialysis were adjusted for sex, blood pressure, and the presence of CKD at the time of screening. CKD was defined as the presence of proteinuria or estimated creatinine clearance of less than 60 ml/min. Among the 13,983 screenees, 7,477 subjects were grouped into CKD. We identified 121 CVD and 116 dialysis patients. Presence of CKD was a significant predictor of CVD; the adjusted hazard ratio 2.650 and the 95% confidence interval of 1.693-4.148, P < 0.0001. Results support the notion that the presence of CKD is an important predictor of CVD.