WHAT IS THE RATIONALE FOR NOT TAKING FREQUENT FOLLOW-UP MEASUREMENTS OF SERUM LIPIDS? Prior guidelines have emphasized treatment escalation to achieve specific LDL-C targets by increasing the dose of statin and/or combination therapy.1,18 Given the lack of data to support this approach,19 the substantial variability in LDL-C measurements,20 and the potential for comedication-related toxicity, this approach is not recommended for people with CKD (see guideline 1.2). As higher risk of future coronary events rather than elevated LDL-C is the primary indication to initiate lipid-lowering treatment in CKD patients, follow- up monitoring of LDL-C (after an initial measurement) will not usually be required for many patients especially given normal variability in LDL-C over time, which reduces the clinical utility of follow-up measurements.21 In the judgment of the Work Group, follow-up measure- ment of lipid levels should be reserved for instances where the results would alter management. Potential reasons to measure the lipid profile in follow-up for people with CKD could include the following: assessment of adherence to statin treatment; change in renal replacement therapy modality or concern about the presence of a new secondary cause of dyslipidemia; or to assess 10-year cardiovascular risk in patients aged o50 years and not currently receiving a statin (because knowledge of LDL-C in this case might suggest that a statin was required see recommendation 2.2). In the judgment of the Work Group, it is unnecessary to measure LDL-C in situations where the results likely would not change management. For example, patients already receiving a statin (or in whom statin treatment is clearly indicated/not indicated based on changes in their cardiovas- cular risk profile or clinical status) would not require follow- up LDL-C measurements because the results would not alter management. 