This study was aimed to observe the tongue image characteristics at different renal function stages among 157 chronic kidney disease (CKD) patients. Tongue images of 157 CKD cases and 30 healthy people were recorded with the instrument designed by Shanghai University of Traditional Chinese Medicine. Parameters of the tongue image were compared among different renal function stages. The results showed that compared with the control group, there were obvious decreasing on the R and L indexes in groups of different renal function stages (P < 0.05). Compared with the control group, there were obvious decreasing on the G and B indexes in groups of CKD1, CKD2, CKD3 and CKD4 stages (P < 0.05). Compared to CKD4 stage, there were obvious decreasing on the R, G, B, L indexes from group of CKD1 and CKD2 stage (P< 0.05). Compared with the group of CKD5 stage, there were obvious decreasing in the group of CKD1, CKD2, and CKD3 (P< 0.05). Compared with the control group, the cracking index was obvi-ous increased in 5 stages (P < 0.05). There was obvious difference in the greasy index between the group of CKD5 stage and the control group (P< 0.05). Compared with the control group, there was obvious difference in the peeling index from the group of CKD3, CKD 4, CKD5 stage (P < 0.05). Along the decreasing of renal function, compared with the group of CKD5 stage, there was obvious decreasing on the greasy index and peeling index in the group of CKD1 and CKD2 (P< 0.05). It was concluded that Chinese medicine tongue and face diagnosis instrument can pro-vide certain objective evidence for the clinical diagnosis of CKD.