Aims/hypothesis: To investigate the rate of anemia in Chinese type 2 diabetes patients, and whether anemia is associated with an increased risk of renal disease progression, as well as the interaction between anemia and glomerular filtration rate (GFR) on renal disease progression.Methods: This was a longitudinal study.1645 Chinese type 2 diabetes patients without end stage renal disease (ESRD) were recruited to the Staged Diabetes Targeting Management Study in Nanjing, China during Jan 2006 and Dec 2012.All patients were managed by Staged diabetes management protocol, and clinical parameters were collected at each visit.The endpoint of progression of renal disease was evaluated during the follow-up.Cox regression analysis was used to estimate the risk of anemia and GFR on renal disease progression.Results: On recruitment, 350 (21.3%) patients had anemia, which was more common among those with older ages, longer diabetes duration, lower estimated GFR (eGFR) or more albuminura.On median follow-up of 49 months (inter-quartile range: 28-62 months), 37 (2.2%) patients developed the defined renal endpoint.Compared to those without anemia, patients with anemia had a higher risk of renal disease progression.Moreover, patients with both anemia and eGFR less than 60 ml/min/1.73m2 at baseline had the highest risk.However, multivariate analysis revealed that anemia at baseline lost its statistical significance once eGFR was added into the model.In addition, although the incidence of renal disease progression markedly increased by anemia status in patients of eGFR less than 60 ml/min/1.73m2, anemia was not an independent risk factor for renal disease progression in this subgroup.Conclusions/interpretation: Anemia was a common finding in Chinese type 2 diabetes patients.Anemia was a risk factor for renal disease progression but lost its significance once baseline renal function was adjusted, indicating that anemia had a significant interaction with baseline eGFR.