Objective: We evaluated the association between inflammation and oxidative stress with carotid intima media thickness (cIMT) and elasticity increment module (E) in pediatric patients with chronic kidney disease (CKD). Methods: This analytical, cross-sectional study assessed 134 children aged 6-17 years with CKD. Anthropometric measurements and biochemistry of intact parathyroid hormone (iPTH), high-sensitivity C-reactive protein (CRP), interleukin (IL)-6, IL-1β, reduced glutathione (GSH), malondialdehyde, nitric oxide, and homocysteine were recorded. Bilateral carotid ultrasound (US) was taken. Patients were compared with controls for cIMT and E using ≥ 75 percentile (PC). Results: Mean cIMT was 0.528 ± 0.089 mm; E was 0.174 ± 0.121 kPa × 10; cIMT negatively correlated with phosphorus ( r −0.19, p = 0.028) and the calcium × phosphorus (Ca × P) product ( r −0.26, p = 0.002), and positively with iPTH ( r 0.19, p = 0.024). After adjusting for potential confounders, hemodialysis (HD) (β = 0.111, p = <0.001), automated peritoneal dialysis (APD) (β = 0.064, p = 0.026), and Ca x P product (β = −0.002, p = 0.015) predicted cIMT ( R = 0.296). In patients on dialysis, HD (β = 0.068, p = 0.010), low-density lipoprotein cholesterol (LDL-C) (β = 0.001, p = 0.048), and GSH (β = −0.0001, p = 0.041) independently predicted cIMT ( R = 0.204); HD, hypoalbuminemia, and high iPTH increased the risk of increased cIMT. In dialysis, E was inversely associated with GSH, and in predialysis, Ca × P correlated with/predicted E (β = 0.001, p = 0.009). Conclusions: cIMT and E strongly associate with several biochemical parameters and GSH but not with other oxidative stress or inflammation markers. [ABSTRACT FROM AUTHOR]