Dyslipidaemia is a well-recognized risk factor for cardiovascular disease (CVD) in chronic kidney disease (CKD). We evaluated the relationship of lipoprotein biomarkers to AsVD among stage 3 CKD and ESKD patients on renal replacement therapy (peritoneal dialysis (PD) and haemodialysis (HD) and KTRs) This was a cross-sectional study of 40 adult (18-65 years) non-diabetic stage 3 CKD patients, 40 PD and 40 HD patients, 41 KTRs and 41 age- and sex-matched healthy controls. An interviewer-administered questionnaire was used to obtain information on participants’ sociodemographic and cardiovascular risk factors. Serum was analysed for creatinine, albumin, lipid profile, lipoprotein markers including lipoprotein(a) Lp-PLA2 and apolipoprotein A1 and inflammatory markers such as hsCRP, pentraxin-3, TNF-α and EN-RAGE. Lipoprotein ratios including Castelli indices 1 and 2, atherogenic coefficient (AC), atherogenic index of plasma (AIP), non-HDL-C and lipoprotein combined index (LCI) were calculated. Echocardiography was performed on all patients and carotid intima media thickness (CIMT) was assessed The levels of Lp(a) and Lp-PLA2 were increased in all kidney disease groups. Significantly higher levels of Lp(a) were seen in PD, HD, KTRs and the combined kidney disease group, compared to controls (p < 0.02) while lower levels of APO A1 were seen in all kidney disease groups. Significantly higher values of Castelli index 1, AC and non-HDL-C were seen in PD patients when compared to controls and CKD stage 3, (p < 0.031). Castelli 1 and 2 and AC correlated positively with CIMT in the combined kidney disease patients. Age (> 40 years) [OR 5.00, p < 0.001], male gender [OR 3.24, p = 0.005], low HDL-C levels [OR 3.14, p = 0.008] and elevated Lp (a) levels [OR 2.23, p = 0.048] independently predicted AsVD. Lipoprotein (a) predicted AsVD better than other lipid markers evidenced by higher AUC on ROC curve. The burden of abnormal lipid biomarkers was greater among ESKD patients and the highest burden was in PD patients while lipoprotein ratios were increased in the kidney disease patients. KTRs had a more favourable lipid biomarker profile compared to dialysis patients. Lipoprotein(a) was a better surrogate marker for AsVD among female kidney disease patients when compared with other lipoprotein biomarkers, and lipid profile parameters. Therapeutic efforts directed at lowering Lp(a) levels may be beneficial in CKD patients