Introduction Our study aims to analyze the relationship between different stage of Cardiovascular-Kidney-Metabolic (CKM) Syndrome in Chronic Kidney Disease (CKD) patients and the risk of progression to all-caused mortality or end-stage renal disease (ESRD).Methods and results A retrospective cohort study was performed by collecting baseline data of CKD patients. All participants were followed throughout the course of the study. Cox proportional hazards analysis and Fine-Gray subdistribution model was performed to analyze the prognostic value of different CKM stages on the risk of adverse clinical outcomes (all-caused mortality or progression to ESRD) of these patients. 1,358 patients finally completed the follow-up. Among them, 1,233 patients were alive, and 125 patients had died; and 163 patients progressed to ESRD. Baseline CKM stage 3 (OR=3.906, 95% CI=0.988-16.320, p=0.048) and stage 4 (OR=5.728, 95% CI=1.329-24.698, p=0.019) remain independent risk factors for all-cause mortality in CKD patients, while CKM stage 2b (OR=2.739, 95% CI=1.157-6.486, p=0.022) were identified as having an independent risk factor for progression to ESRD in CKD patients by adjusting confounding factors.Conclusion Our research demonstrated that a high-risk CKM stage can predict adverse clinical outcomes in CKD patients, including all-cause mortality and progression to ESRD.