Hardening of the arteries (atherosclerosis) is a disease of blood vessels associated with high blood pressure and elevated blood cholesterol levels. It is also passed down in families and is thought to be related to genetics. The treatment in patients with chronic kidney disease (CKD) is the same as treatment in people who do not have CKD. Blood pressure control should be established to less than 130/80. Blood cholesterol levels should generally be treated with a statin drug. If diabetes is present, diabetes should be carefully controlled. You should maintain a healthy body weight, follow a low salt diet and exercise on a regular basis. If the narrowing in the left carotid artery is significant and there are symptoms related to the narrowing, surgical treatment may be needed. I also commonly recommend treatment with low dose aspirin.