The Work Group further suggests that the patient s age could also be considered when applying this recommendation. Due to the very limited available data, the Work Group does not recommend the use of statins in children with CKD aged o10 years. Patients (boys aged 410 years and post- menarchal girls, together with their parents) with severely elevated LDL-C who place a higher value on the potential for preventing cardiovascular events and are less concerned about adverse events from statin use might be candidates for statin use especially those with multiple additional risk factors such as family history of premature coronary disease, diabetes, hypertension, smoking and ESRD. If a statin is prescribed, the Work Group suggests the lowest dose available. There are no data on the appropriate target for LDL-C in children (with or without CKD), extremely limited long-term safety data in pediatric CKD populations, and no dose escalation studies in children with CKD to confirm the safety of higher statin doses even over the short term. Given the lack of evidence for the benefit and safety of combination therapy with bile acid resins, colestipol and ezetimibe in pediatric CKD populations, the Work Group does not recommend the use of such multi-drug regimens even in children with severely elevated LDL-C. Suggested Audit Criteria K Determine the number of children treated with statins (and statin type) and other lipid-lowering therapies by CKD severity. K Document the number of children with intolerance and/ or non-compliance to statins or other lipid-lowering treatment. K Document the number of children that receive statin therapy for primary prevention. chapter 4 http://www.kidney-international.org & 2013 KDIGO KEY POINTS K TLC should be recommended to all children with CKD and dyslipidemia. K Statins are not recommended for children with CKD and dyslipidemia. 