Background <p>High interleukin-6 (IL-6) and low albumin levels in circulating blood have been confirmed among patients with advanced chronic kidney disease (CKD), linking with adverse clinical events.</p> Aim <p>We explored whether serum IL6-to-albumin ratio (IAR) can be an indicator for predicting cardiovascular events and mortality risk among patients with mild or moderate CKD.</p> Methods <p>We used IAR value as the exposed factor of cardiovascular events and mortality risk among a total of 206 patients with mild to moderate CKD. The composite event (cardiovascular events) included myocardial infarction, angina pectoris, stroke, peripheral artery disease and heart failure, and the mortality was defined as the cardiovascular death during a follow-up for 36 months.</p> Results <p>Our results showed that the IAR (AUC  0.875) had a strongest ability on predicting the composite event than serum IL6 (AUC  0.713) and albumin (AUC  0.635). Cox regression analysis also showed that the IAR was significantly and independently associated with an increased rate of composite event and mortality risk, with the hazard ratio of 3.1 (95% CI 1.6, 5.8; P &lt; 0.01) and 2.2 (95% CI 1.3, 3.5; P &lt; 0.01) respectively, after adjusting for age, gender, smoking history, drinking history and medical history (primary hypertension, diabetes, stroke and heart disease).</p> Conclusions <p>A higher IAR value was independently associated with an increased risk for cardiovascular events and mortality among these patients with mild to moderate CKD. The evidence suggested that IAR might be as a potential indicator for identifying adverse cardiovascular events and mortality among these patients.</p>