Background: Chronic kidney disease (CKD) is characterized by irreversible kidney damage and/or progressive loss of function. Patients with CKD have hypertension and dyslipidemia, which lead to carotid intima media thickness and early atherosclerosis. Objective: This study aimed to evaluate the interrelationship between vascular and lipid profile abnormalities and the different stages of CKD in pediatric patients. Methods: This cross-sectional study was done on 99 patients:33 with stage 5 CKD on regular hemodialysis & 33 pre-dialysis CKD stage 2-4 on conservative management & 33 age and sex matched controls. Anthropometric measures, blood pressure readings, and a lipid profile were done to all groups. Intima media thickness was measured using ultrasound Doppler in both the common and internal carotid arteries (CCA & ICA) Results: The waist-to-hip ratio in CKD 2-4 patients was significantly higher than in CKD 5 patients, and both were higher than the controls, with means of 1.01 ± 0.19, 0.88 ± 0.10, and 0.86 ± 0.05 respectively. Except for high-density lipoproteins (HDL), the lipid profile, including triglycerides, cholesterol, and low-density lipoproteins (LDL), were all significantly increased when comparing CKD 2-4 with CKD 5, and both were higher than the controls: 170.45 ± 42.04, 166.00 ± 45.57, and 100.88 ± 26.19 for triglycerides (p 0.001). The right and left ICA and CCA showed a significant increase in the intimal thickness being higher in the CKD 5 group than in the CKD 2-4 and both were higher than the controls. Conclusion: Patients with CKD had a higher waist to hip ratio with elevated lipid profile and carotid intimal thickness.