Values for plasma lipid and lipoprotein levels are from the National Cholesterol Education Program (NCEP) Expert Panel on Cholesterol Levels in Children. Non-HDL C values from the Bogalusa Heart Study are equivalent to the NCEP Pediatric Panel cut points for LDL C. Chapter 4: Pharmacological cholesterol-lowering treatment in children 4.1: In children less than 18 years of age with CKD (including those treated with chronic dialysis or kidney transplantation), we suggest that statins or statin/ezetimibe combination not be initiated. (2C) RATIONALE Clinical trials of dyslipidemias are limited in the pediatric CKD population given the rapid transitions from CKD to dialysis and/or transplant, which complicates trial design, recruitment and analyses (Supplemental Table 32 online). Accurately predicting CVD risk is also not possible in the pediatric CKD population given the limited data available; scores commonly used in adults have not been validated in the pediatric population. Nonetheless, young adults ages 20 24 treated with dialysis or kidney transplantation have significantly lower expected survival compared to an age-matched group in the general Treatment for dyslipidemia in children should first include nutrition and dietary counseling, and address obesity with weight loss regimens if necessary. Recent studies in the general population have shown that dietary fat restriction is safe in children.67 70 In particular, there have been no adverse effects on growth and development, or nutrition.67 70 Diets, however, should be used judiciously, or not at all, in children who are malnourished. Secondary causes of dyslipidemias should also be treated first (Table 1). Therapeutic lifestyle changes (TLC) should be adopted among all children with CKD. 