Non-pharmacological treatment of high TGs (4500 mg/ dl; 5.65 mmol/l) includes therapeutic lifestyle changes such as dietary modification, weight reduction, increased physical activity, reducing alcohol intake, and treatment of hypergly- cemia (if present). Evidence that lifestyle changes will reduce serum TGs in patients with CKD is weak, but the elements of lifestyle changes are unlikely to lead to harm and may improve general health. TREATMENT FOR HYPERTRIGLYCERIDEMIA IN CHILDREN AND ADOLESCENTS SHOULD FOCUS ON SEVERE CASES As for adults, the evidence that lifestyle changes will reduce serum triglyceride levels and/or improve clinical outcomes is weak. Nonetheless, it is reasonable to advise children with high fasting levels of serum TGs (45.65 mmol/l (4500 mg/dl)) to adopt lifestyle changes, but dietary modi- fication should be used judiciously, if at all, in children who are malnourished. The safety and efficacy of lowering TGs with fibrates and niacin have not been established in adolescents; fish oil appears to lower serum TGs after as little as 12 weeks of therapy,40 43 but the longer-term benefits, harms, and tolerability of such treatment is unclear. DISCLOSURE MT, Advisor/Consultant: Merck (honoraria donated to charity). CW, Speaker: Astellas-Pfizer (Japan); Merck & Merck Sharp Dohme. ACKNOWLEDGMENTS We thank the KDIGO cochairs Bertram L. Kasiske and David C. Wheeler; the evidence review team (Ashish Upadhyay, Ethan Balk, Amy Earley, Shana Haynes, Jenny Lamont, Michael Cheung); and all those who provided feedback during the public review of the draft guideline. MT was supported by an AHFMR Population Health Scholar award and a Government of Canada Research Chair in the optimal care of people with CKD. SUPPLEMENTARY MATERIAL Table S1. GRADE Criteria Used for Grade Levels in the KDIGO Lipid Guideline. Table S2. GRADE Criteria Used for Letter Grades in the KDIGO Lipid Guideline. 