In the judgment of the Work Group, these considerations justify a strong recommendation despite the low quality of the available evidence. 1.2: In adults with CKD (including those treated with chronic dialysis or kidney transplantation), follow-up measurement of lipid levels is not required for the majority of patients. (Not Graded) RATIONALE Prior guidelines have emphasized treatment escalation to achieve specific LDL-C targets by increasing the dose of statin and/or combination therapy.1,7 Given the lack of data to support this approach in populations with and without the substantial within-person variability in LDL-C and the potential for medication-related toxicity, this approach is no longer recommended for CKD populations (see guideline 2). Since higher cardio- vascular risk and not elevated LDL-C is now the primary indication to initiate or adjust lipid-lowering treatment in CKD patients, follow-up monitoring of LDL-C (after an initial measurement) may not be required for many patients especially given normal variability in LDL-C over time, which reduces the clinical utility of follow- In the judgment of the Work Group, follow-up measure- ment of lipid levels should be reserved for instances where the results would alter management. Potential reasons to measure LDL-C (or the lipid profile) in people with CKD after their initial presentation might include: assessment of adherence to statin treatment; change in RRT modality or concern about the presence of new secondary causes of dyslipidemia (Table 1); or to assess 10-year cardio- vascular risk in patients aged o50 years and not currently receiving a statin (because knowledge of LDL-C in this case might suggest that a statin was required see Recommenda- tion 2.2). In the judgment of the Work Group, it is unnecessary to measure LDL-C in situations where the results would not (or likely would not) change management. 