The estimate of effect is very uncertain, and often will be far from the truth. WHY SHOULD WE OBTAIN A FULL LIPID PROFILE IN ALL CKD PATIENTS AT FIRST PRESENTATION? The major factors predisposing to dyslipidemia in people with CKD are lower GFR, the presence of diabetes mellitus, more severe proteinuria, the use of immunosuppressive agents, modality of renal replacement, comorbidity, and nutritional status.14 Initial evaluation of the lipid profile is intended to diagnose severe hypertriglyceridemia and/or hypercholesterolemia while ruling out any underlying secondary causes. Medical conditions that cause secondary dyslipidemias include hypothyroidism, excessive alcohol consumption, nephrotic syndrome, diabetes mellitus, and liver disease. Medications that may lead to dyslipidemias include corticosteroids, diuretics, 13-cis-retinoic acid, review C anticonvulsants, oral contraceptives, highly active antiretro- viral therapy, b-blockers, cyclosporine, and sirolimus. The lipid profile should ideally be measured in patients who have been fasting. However, if this is not feasible, non- fasting values provide useful information as well.15 Fasting specimens will be needed if significant lipid abnormalities are found on initial measurements, especially severe hypertri- glyceridemia.15 17 In the opinion of the Work Group, fasting TG levels above 11.3 mmol/l (1000 mg/dl) or LDL-C levels above 4.9 mmol/l (190 mg/dl) should prompt specialist referral for further evaluation. No direct evidence indicates that measuring lipid status will lead to better clinical outcomes. However, measuring lipid status is noninvasive, inexpensive, and might improve the health of people with secondary dyslipidemia. In the judgment of the Work Group, these considerations justify a strong recommendation despite the low quality of the supporting evidence. WHAT IS THE RATIONALE FOR NOT TAKING FREQUENT FOLLOW-UP MEASUREMENTS OF SERUM LIPIDS? 