The principal findings of the study were as follows: (1) the prevalence of SMI was higher in the CKD group and its incidence was proportional to the CKD stage, (2) patients with SMI and severe CKD had poor long-term outcomes, and (3) urinary albumin (mg/gCr) was an independent predictor of poor prognosis in diabetic patients with SMI. Here, ALB is linked to chronic kidney disease.