Background It has been long suggested that abnormal clinical factors in the body,such as dyslipidemia and diabetes.can affect the presence of atherosclerosis.However,few studies on the effect of factors within the normal range,such as the loss of renal function with age,on the prevalence of atherosclerosis are few know in healthy individuals.The aim of this study was to investigate risk factors affecting the presence of asymptomatic carotid plaques in a middle-aged and elderly healthy population.Methods In this regard,we prospectively evaluated 245 healthy individuals (98 males and 147 females) at baseline and after 5 years.Changes in the presence of carotid plaque between 2003 and 2008 were categorized into four groups,i.e.subjects without plaque at entry (n=165):Group 1 (without plaque on two occasions,n=129) and Group 2 (with nascent plaque at follow-up,n=36); subjects with plaque at entry (n=80); Group 3 (with plaque regression at follow-up,n=29) and Group 4 (with plaque on two occasions,n=51).Results Univariate analysis showed that the positive rate of carotid plaques in males was higher than that in females at the baseline,and that a significantly inverse correlation existed between the prevalence rate of plaque and aging.Logistic regression analysis of cross-sectional research showed that independent risk factors for the prevalence of atherosclerosis were male gender,lower estimated glomerular filtration rate (eGFR) and higher low-density lipoprotein cholesterol (LDL-C) at the baseline,and older age and lower eGFR were involved in the presence of carotid plaques at follow-up point.However,logistic regression analysis of the longitudinal data showed that older age,decreased eGFR and increased systolic blood pressure (SBP) independently predicted the presence of carotid plaques after 5 years in subjects without plaque at entry.In addition,in subjects with plaque at entry,age,changes in eGFR and the baseline levels of serum albumin (ALB) and serum total bilirubin (BIL) dependently influenced the outcome of carotid plaque.Conclusion Physiological decline of renal function,together with advancing age,was an independent risk factor which consistently affected the presence of carotid atherosclerosis in two categories of healthy individuals.