Objective To study the differences in the distribution of exfoliated cells of tongue coatings in different tongue manifestations of patients with chronic kidney disease（CKD）. Methods A total of 80 CKD patients in phase Ⅲ and Ⅳ were selected to determine the types of their tongue coatings macroscopically. The tongue coating exfoliated cells were collected to make specimens

and the maturity index（MI）

maturity value（MV） of exfoliated cells of tongue coatings in different tongue manifestations were detected. Another 20 healthy people were selected as control group. The tongue body

the color and thickness of tongue coating and MI

MV in control group were compared. Results The differences of MI、MV of superficial and mid-layer exfoliated cells of tongue coatings in light red tongue group

pale tongue group

red tongue group and control group had no statistical significance（P > 0. 05）.MI

MV of superficial exfoliated cells of tongue coatings in yellow coating patients were higher than control group and white coating patients

while the MI of mid-layer cells was lower（P < 0. 01）. MI

MV of superficial exfoliated cells of tongue coatings in thick coating patients were higher than control group and thin coating patients

and the control group was higher than thin coating group（P < 0. 01）. MI of mid-layer exfoliated cells of tongue coatings in thick coating patients was lower than thin coating group（P < 0. 05）. Conclusion MI and MV distribution of exfoliated cells of tongue coatings is relevant to the coating nature of CKD patients. MI of superficial layer cells of yellow coating and thick coating is highest

mid-layer cell of tongue coatings the lowest. This can be used to identify the tongue manifestation.