Future cardiovascular risk is often assessed using the 10-year incidence of coronary death or non-fatal MI, numerically equivalent to the rate of such events per 1000 patient-years. There is debate about the level of future coronary risk that is sufficient to justify statin treatment, but in the Work Group s judgment a rate of coronary death or non-fatal MI that exceed 10 per 1000 patient-years is a reasonable criterion. The rate of coronary death or incident MI among CKD patients aged 450 years (both men and women) is consistently 410 per 1000 patient-years, even in those without diabetes or prior MI. In contrast, the rate of coronary death or incident MI among CKD patients aged p50 years is low in those without diabetes or prior MI (although it is substantially higher than in people with similar characteristics but without CKD). For comparison, the recent 2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults suggests an estimated 10-year risk for a first hard atherosclerotic cardiovascular disease event of 47.5% (estimated using the new Pooled Cohort Equations in the CVD-free, non-pregnant US Population 40 to 79 years of age) as an indication to initiate Available evidence argues against the use of LDL-C to identify people with CKD who should receive statin treatment and suggests focusing on two other factors:1 the absolute risk of coronary events and2 the evidence that statin treatment is beneficial. This is the approach taken in the following KDIGO recommendations. 