, 1.8 or 2.6 mmol/l [70 or 100 mg/dl]), which require repeated measurements of LDL-C and treatment escalation with higher doses of statin or initiation of combination lipid-lowering therapy ( treat-to-target strategy) when the LDL-C target is not met. The KDIGO Work Group does not recommend the treat-to- target strategy because it has never been proven beneficial in any clinical trial. In addition, higher doses of statins have not been proven to be safe in the setting of CKD. Therefore, the Work Group recommends a fire-and-forget strategy for patients with CKD (see Rationale for Recommendation 1.2). Physicians may choose to perform follow-up measurement of lipid levels in patients for whom these measurements are judged to favorably influence adherence to treatment or other processes of care. summary of recommendation statements Introduction: The case for updating and context In 2003, the US-based KDOQI (Kidney Disease Outcomes Quality Initiative) group published Clinical Practice Guide- lines for Managing Dyslipidemias in Chronic Kidney Disease (CKD). In the absence of randomized controlled trials (RCTs), ATP III Guidelines (Adult Treatment Panel III) were considered to be generally applicable to patients with estimated glomerular filtration rate (eGFR) Z15 ml/min/ (GFR categories G1-G4, formerly CKD stages 1 4) with the exception that: (1) CKD was classified as a coronary heart disease (CHD) risk equivalent, (2) complications of lipid-lowering therapies may result from reduced kidney function, (3) indications for the treatment of dyslipidemias other than preventing acute cardiovascular disease (CVD) may be applicable, and (4) treatment of proteinuria might also be an effective treatment for dyslipidemias.1 At that time the Work Group included children and adolescents with CKD (defined by the onset of puberty) in these guidelines, and recommended that they be managed in the same way as adults. 