Aim: The aim was to describe the occurrence of chronic kidney disease stage 3 (CKD) in a middle-aged population in Sweden and the development over ten years time. We also aimed to examine the predictive value of lipoproteins. Method: A random sample of 2816 individuals (30-75 years) in a middle-sized town in southwestern Sweden, was examined in this population-based study. Fasting venous samples were drawn for s-creatinine, total cholesterol, HDL, LDL, ApolipoproteinA1 (ApoA1), ApolipoproteinB (ApoB) and triglycerides. Morning urine was collected for albumin and creatinine. The participants were examined with regard to blood pressure, body weight and height. After a mean follow-up time of 9.7 years, 1323 of the original participants were re-examined following the same protocol and in the analyses of occurrence of KKD. CKD was defined as eGFR ≤60 ml/min/1.73m2 (calculated with the CKD-Epi equation), and after excluding 28 participants with nephropathy at baseline and 37 participants due to missing data, 1267 individuals (632 men, 635 women) remained for further analyses regarding incident CKD. Results: Mean age at baseline was 48.9 years (SD 11.5) and mean BMI was 26.7 kg/m2 (SD 4.7). The occurrence of CKD increased from 2.1% at baseline to 8.3% after ten years. Baseline ApoA1 predicted CKD at follow-up when adjusted for age, BMI, systolic blood pressure and creatinine at baseline. There was a non-significant interaction between sex and ApoA1 in relation to CKD at baseline (p=0.151) and sex-stratified analyses showed a relationship in men but not in women. Neither ApoB, the ratio ApoB/ApoA, total cholesterol, HDL nor LDL had any predictive effect on CKD at follow-up when accordingly adjusted. Conclusion: The occurrence of CKD in this fairly young Swedish population was 2.1% at baseline, and increased fourfold after ten years follow-up. The results also show that ApoA1 may be used as a risk marker for the development of CKD, particularly in men, and may suggest a more aggressive treatment with statins in individuals at risk of kidney disease.