Lipid abnormalities are almost a constant feature of kidney disease. However, the contribution of deranged lipid metabolism to the increased incidence of cardiovascular disease among renal patients has not been definitely established. Conversely, the role of lipid abnormalities in the progression of renal disease has gained considerable experimental support. Both dietary and pharmacologic interventions, which reduce circulating lipid levels, have been proven to decrease the incidence of glomerulosclerosis in various animal models. Whether similar results can be achieved in renal patients is, at present, unknown. If the new lipid-lowering drugs prove useful in preventing the progression of both glomerulosclerosis and atherosclerosis, a major advance in the therapy for renal patients will be achieved.