In the adjusted regression model, age ≥60 years (PR: 1.232 [CI 95%:1.091–1.390], p value = .001), ACR ≥30 mg/g (PR: 1.176 [CI 95%: 1.007–1.373], p = .040), and GFR/CKD-EPI using cystatin C (PR: 1.250 [CI 95%: 1.004–1.557], p = .045) were independently associated with carotid atherosclerosis. This evidence concerns the gene CST4 and carotid atherosclerosis.