Dyslipidemia in end-stage renal disease is a common problem and may co
ntribute to the high rates of morbidity and mortality in this populati
on. Recent studies indicate that defective lipolysis is a major factor
in the development of this disorder which is characterized by increas
ed levels of very-low-density-lipoprotein remnant particles, hypertrig
lyceridemia and occasionally hypercholesterolemia. There are no prospe
ctive longterm studies on the effect of lipid-lowering treatment on mo
rbidity and mortality related to dyslipidemia, Therefore, at present p
harmacologic treatment of hyperlipidemia should be undertaken in patie
nts with severe hypertriglyceridemia (> 500 mg/dl) or hypercholesterol
emia (LDL > 130 mg/dl) who are at high risk for coronary artery diseas
e. This review discusses the pathogenesis of dyslipidemia, common clin
ical patterns of hyperlipidemia and various nonpharmacologic and pharm
acologic treatment options.