Objective · To analyze the relationships between the carotid structure and the shear rate (SR) in the patients with end-stage renal disease (ESRD) and the kidney transplant recipients(KTR), and to explore the effects of SR on the carotid structure. Methods · Thirty-one KTR, 31 patients with ESRD supported by hemodialysis and 84 control subjects were offered an ultrasound of carotid artery. Both sides of carotid intima-media thickness (CIMT), common carotid arterial diameter (CCAD) and SR were measured and their relationships were analyzed. Results · ① Compared with KTR group and control group, ESRD group had significantly thicker CIMT and wider CCAD , but there was no significant difference between KTR group and control group. ② In the ESRD and KTR group, the SR was less than that in control group respectively. There was no significant difference in SR between ESRD and KTR group. ③ In all subjects, CIMT and CCAD were all negative relative with SR. Moreover, in subgroups analysis, CIMT and CCAD were negative linear relative with SR in three groups respectively. Conclusion · The carotid artery was reconstructed in ESRD group, but was improved after successful kidney transplantation. The SR played a vital role in this alteration.