Objectives: Although with the recent trend of increasing prevalence in elderly diabetic patients, the relationship between diabetic retinopathy (DMR) and chronic kidney disease (CKD) in elderly type 2 diabetic patients is unclear. This study aimed to investigate renal function and advanced CKD in elderly type 2 diabetic patients according to the degree of diabetic retinopathy. Methods: We screened a total of 116 diabetic patients with chronic kidney disease stage ≥ 3 who visited both nephrology and ophthalmology outpatient department from October 2021 to January 2022. All of 116 patients were classified into 53 no DMR group, 20 non-proliferative diabetic retinopathy (NPDR) group, and 43 proliferative diabetic retinopathy (PDR) group. Results: As diabetic retinopathy progressed, the deterioration of renal function was correlated (rₛ=0.531 in creatinine, p<0.001, and rₛ=-0.522 in estimated glomerular filtration rate, p<0.001). And, the proportion of advanced CKD increased significantly as diabetic retinopathy progressed (p for trend <0.001). In multivariate regression model adjusted with very old (≥80years), male, poorly controlled diabetes, macroalbuminuria, insulin use, diabetes duration ≥10years, old cerebrovascular accident, hypertension, hyperlipidemia, and cardiovascular disease history, the odds ratio compared to the no DMR group was about 4.6 for the NPDR group and about 11.8 for the PDR group, which was statistically significant (p=0.025 in NPDR group, and p<0.001 in PDR group). Conclusions: The progression of diabetic retinopathy in elderly type 2 diabetic patients may be associated with deterioration of renal function and high proportion of advanced CKD. Therefore, periodic examination for diabetic retinopathy in elderly type 2 diabetic patients is important to predict the prognosis of renal function deterioration and progression of chronic kidney disease. In addition, the attention and effort of a nephrologist is required so that the ophthalmic examination can be performed properly.