Atherosclerosis is accelerated in dialysis patients, but less is known about asymptomatic atherosclerosis and major risk factors in patients with different stages of chronic kidney disease (CKD). We compared intima media thickness (IMT) and plaque occurrence in the carotid arteries in 104 nondiabetic patients (stages 1-5 of CKD; mean age: 51.6 years) with those in 40 healthy control subjects. The IMT values (0.69 vs. 0.59 mm; P < 0.002) were higher in patients. More patients had plaques (46.2 vs. 17.5%; P < 0.002), and number of plaques was higher (P < 0.003). Negative correlation between IMT (P < 0.0001), presence of plaques (P < 0.0001), their number (P < 0.040), and chromium 51-labeled ethylenediaminetetraacetate ((51)Cr-EDTA) clearance were found in patients. With multiple regression analysis, relationship between IMT and (51)Cr-EDTA clearance (P < 0.001) and presence of hypertension (P < 0.001) was found. Nondiabetic patients with CKD showed advanced atherosclerosis and IMT, plaque occurrence, and number increased directly with the level of renal dysfunction. Another important risk factor was hypertension.