Background: Chronic kidney disease (CKD) is associated with an adverse prognosis in patients with coronary heart disease. Cardiac rehabilitation (CR) improves morbidity and mortality among patients with coronary heart disease, but its impact on patients with concomitant CKD has not been described. Methods: We compared baseline characteristics of patients with CKD (calculated glomerular filtration rate <60 mL/min per 1.73 m2) and without CKD who completed CR between 1996 and 2004 using t tests and χ2 tests. CR outcomes were evaluated by comparing the degree of change in clinical and behavioral variables within and between groups with paired and unpaired t testing, respectively, and by comparing the proportion of patients who achieved secondary prevention goals between groups using χ2 testing. Results: Among 376 patients, CKD was present in 115 (31%). Patients with CKD were older, had more cardiac risk factors and comorbidities, and had lower functional capacity and perceived health status than patients without CKD. Both groups achieved significant improvements in diet scores, body weight, lipid profiles, 6-minute walk distances, physical activity level, and perceived health status. The proportion of patients who achieved secondary prevention goals was also similar, but patients with CKD continued to have lower high-density lipoprotein cholesterol, lower physical component health status summary scores, and lower functional capacity than patients without CKD. Conclusions: CKD is common among CR participants. Patients with CKD have a high cardiovascular risk factor and comorbidity burden. CR is as effective in improving coronary risk profiles among patients with CKD as it is among patients with normal renal function. © 2005, Mosby, Inc. All rights reserved.