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Arterial stiffness, assessed by estimated pulse wave velocity (ePWV), is a valuable non\u2010invasive indicator of vascular health. However, the association between ePWV and carotid plaques in CKD stages 3\u20135 remains unclear. Of the 296 participants, 199 were included in the cross\u2010sectional study after applying exclusion criteria. Carotid plaques were assessed using ultrasound, and ePWV was calculated based on established equations. Logistic regression models examined the association between ePWV and carotid plaques, while subgroup and mediation analyses evaluated the robustness of the association and mediating effects, respectively. ePWV was significantly associated with carotid plaques (OR: 1.85; 95% CI: 1.47\u20132.32; <jats:italic>p<\/jats:italic> &lt; 0.001) after adjusting for covariates. The highest ePWV tertile (ePWV \u2265 11.2 m\/s) was associated with a markedly increased risk of carotid plaques compared to the lowest tertile (OR: 21.52; 95% CI: 7.09\u201365.36; <jats:italic>p<\/jats:italic> &lt; 0.001), and trends between tertiles have been observed. Subgroup analysis showed that diabetes influenced the robustness of the association between ePWV and carotid plaque. Mediation analysis revealed that ePWV accounted for 32.9% of the effect of diabetes on carotid plaques, indicating its potential role as a partial mediator. This study identified a robust association between ePWV and carotid plaques in CKD stages 3\u20135, with diabetes significantly influencing this relationship. The findings highlighted the clinical relevance of ePWV in cardiovascular risk assessment and underscored the importance of managing arterial stiffness in advanced CKD populations.<\/jats:p>","DOI":"10.1111\/jch.70103","type":"journal-article","created":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T09:01:34Z","timestamp":1754125294000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association Between Estimated Pulse Wave Velocity and Carotid Plaques in Non\u2010Dialysis CKD Stages 3\u20135: A Cross\u2010Sectional Study"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7073-2827","authenticated-orcid":false,"given":"Li","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Nephrology Zhongshan Hospital Fudan University  Shanghai China"},{"name":"Shanghai Clinical Research Center for Kidney Disease  Shanghai China"},{"name":"Shanghai Institute of Kidney 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