['Patients either with hyperhomocysteinemia or chronic kidney disease (CKD) have an increased risk of cardiovascular disease. Little is known regarding whether hyperhomocysteinemia can increase the risk of CKD in a Chinese middle-aged and elderly population. To help clarify this we conducted a prospective cohort study to measure the association of hyperhomocysteinemia with CKD.', 'A total of 5917 adults aged 56.4\xa0±\xa09.6\xa0years without CKD at baseline were enrolled. The highest homocysteine quartile (≥15\xa0μmol/L) was defined as hyperhomocysteinemia. CKD was defined as decreased estimated glomerular filtration rate (eGFR\xa0<\xa060\xa0mL/min/1.73\xa0m', 'During 3\xa0years of follow-up, 143 (2.4%) patients developed CKD, 85 (1.4%) patients with proteinuria and 59 (1.0%) patients with decreased eGFR. After adjusted for potential confounders, both homocysteine (per 1\xa0μmol/L increase) and hyperhomocysteinemia were independently associated with increased risk of decreased eGFR [with a fully adjusted OR of 1.07 (95% CI 1.04-1.10) and 3.05 (95% CI 1.71-5.46)] and CKD [with a fully adjusted OR of 1.04 (95% CI 1.02-1.07) and 1.62 (95% CI 1.11-2.35)], respectively. By contrast, neither homocysteine (per 1\xa0μmol/L increase) nor hyperhomocysteinemia were associated with proteinuria in the multivariable logistic regression analysis.'] Does hyperhomocysteinemia increase the risk of chronic kidney disease in a Chinese middle-aged and elderly population-based cohort?