This study is being done at Assiut University to look for early signs of hardening of the arteries (atherosclerosis) in people who have both diabetes and chronic kidney disease (CKD). Many patients with these conditions are at higher risk of heart disease and stroke, but the disease can develop quietly without symptoms.

We will use a safe, non-invasive test called carotid Doppler ultrasound, which uses sound waves to check the neck arteries (carotid arteries) for early changes. The goal is to see how often these early changes occur in patients with diabetes and CKD, and whether the findings relate to their kidney function, blood sugar control, and other health factors.

This research may help doctors detect vascular problems earlier and guide better prevention strategies for patients at risk.

1. Age≥18years.
2. Diagnosis of type 2 diabetes mellitus (per treating physician or ADA criteria).
3. CKDstage3:eGFR30-59mL/min/1.73 m² on at least two measurements ≥3 months apart OR established diagnosis in medical record.
4. Clinically stable (no AKI, no hospitalization for cardiovascular event in past 3 months).
5. Ableandwilling to provide informed consent.

Adult patients with type 2 diabetes mellitus and stage 3 chronic kidney disease recruited from the nephrology and internal medicine outpatient clinics and inpatient wards of Assiut University Hospitals.