Chronic kidney disease (CKD) is a progressive condition characterized by persistent inflammation, often indicated by elevated C-reactive protein (CRP) levels. This study aimed to evaluate the relationship between elevated CRP levels and disease progression in CKD patients to elucidate potential prognostic implications. A prospective cohort of 250 CKD patients, stratified into high-CRP (>3 mg/L) and normal-CRP (≤3 mg/L) groups, was followed over 24 months. Clinical endpoints included estimated glomerular filtration rate (eGFR) decline, hospitalization rates, and all-cause mortality.Statistical analyses revealed significantly faster eGFR decline in the high-CRP group (mean decline: 6.4 ± 1.2 mL/min/1.73m²/year) compared to the normal-CRP group (3.2 ± 0.8 mL/min/1.73m²/year, p < 0.001). Furthermore, high-CRP patients exhibited increased hospitalization rates (38.5% vs. 21.6%, p < 0.01) and mortality (14.2% vs. 5.6%, p = 0.03). Multivariate regression confirmed CRP as an independent predictor of CKD progression and adverse outcomes (p < 0.01).These findings suggest that elevated CRP levels may serve as a critical biomarker for adverse outcomes in CKD. This study emphasizes the need for targeted anti-inflammatory interventions in high-risk patients, offering new insights into managing CKD progression.