Tsai CW, et al. - In this registry-based prospective study with 4,647 patients with chronic kidney disease(CKD) aged 20-90 years, researchers investigated the impacts of longitudinal lipid trajectories on end-stage renal disease (ESRD) development and deaths, analyzing data from a 13-year multidisciplinary pre-ESRD care program. Longitudinal trajectories of total cholesterol(T-CHO), TG, LDL cholesterol (LDL-C), and HDL cholesterol (HDL-C) were dichotomized by using group-based trajectory modeling. In association with baseline levels of T-CHO and LDL-C and hyperlipidemic status, rapid progression to ESRD was reported. A positive association of only baseline HDL-C (per 10 mg/dL increase) with all-cause mortality was evident. For ESRD risk, the fully adjusted hazard ratio of patients with a high T-CHO trajectory vs those with a normal T-CHO trajectory was 1.21. Therefore, a significant potential risk of incident ESRD was shown only by T-CHO, both at baseline and over the longitudinal course.