In children with CKD, the relationship between dyslipi- demias and subsequent atherosclerotic clinical events is not known due to short follow-up in observational studies or clinical trials. Recently, the Cardiovascular Risk Reduction in High-Risk Pediatric Patients: A Scientific Statement from the American Heart Association Expert Panel on Population and Prevention Science stated that CVD prevention in many chronic pediatric conditions was warranted given the high risk of developing disease as adults.61 The recent National Institutes of Health Expert Panel on Integrated Guidelines for Cardiovascular Health and Risk Reduction in Children and Adolescents in 2011 addressed specific questions of screening for dyslipidemias in children and adolescents and also treatment of dyslipidemias.7 Cholesterol and its metabolism are important in children as cholesterol is the basis of cell membranes, myelin formation, subcellular organelles and steroid hormones which are all key for natural growth and development. Based on growth and development, lipid levels vary depending on age, puberty, Lipid levels are very low at birth and increase during the first year of life [mean TC of 3.9 mmol/ l (150 mg/dl), LDL-C 2.6 mmol/l (100 mg/dl), and HDL-C 1.4 mmol/l (55 mg/dl)] where they remain fairly constant till age 12 and are slightly lower in girls than boys. During puberty, there is a decrease in TC, LDL-C, and a slight decrease in HDL-C in boys. After puberty, TC and LDL-C increase to adult levels in boys and girls. Boys continue to have a slightly lower HDL-C than girls. Due to these variations in levels, former guidelines used the 95th percentile for age and gender to determine the upper limit of acceptable values. More recently, age- and gender- specific curves for lipoproteins linked to CVD risk over 15-20 years55,58 have been used instead. 