More recently, age- and gender- specific curves for lipoproteins linked to CVD risk over 15-20 years55,58 have been used instead. A simplified and more practical approach has been to define acceptable, borderline high and high lipid concentration for children and adolescents based on these (see Table 5). Many studies document the prevalence of dyslipidemias among children with CKD and ESRD.63,64 As in adults, the pattern of dyslipidemias in children with CKD is greatly influenced by the underlying pathogenesis and duration of CKD, severity of proteinuria, and treatment.63,64 Due to this variability, the prevalence of hypercholesterolemia ranges from 39% to 65% in children with CKD. Among 391 children from the North American observational cohort study, CKiD (Chronic Kidney Disease in Children), TG and non-HDL-C levels increased as the measured GFR declined in this cross sectional study population.63 Conversely, HDL-C was lower for those with a lower GFR. Factors that impacted TG, HDL- C and non-HDL-C levels were primarily GFR, significant proteinuria and obesity by multivariate analyses.63 Over half the population had no evidence of dyslipidemias and of the remainder, 25% had a single abnormal lipid level, and the other 25% had at least 2 abnormal lipid levels.63 The most chapter 3 http://www.kidney-international.org & 2013 KDIGO common abnormality was hypertriglyceridemia.63 The frequency of these abnormalities suggests that clinicians should measure lipid levels at baseline in children with CKD to screen for underlying secondary causes of dyslipidemia. As for adults, there is no direct evidence indicating that measurement of lipid status will improve clinical outcomes. However, such measurement is minimally invasive, relatively inexpensive, and has potential to improve the health of people with secondary dyslipidemia. 