**5.1 Where we stand today?**

From our metaanalysis and the study on the unreliability of LDL-C estimation we conclude that the Friedewald formula seems to be no longer a viable test for appropriate targeted therapy in chronic renal failure and hemodialysis. Direct assays of LDL-C are not absolutely without error but they provide considerably more reliable results as a calculation from three measurements.

Clinicians should be aware that despite our gradually better understanding of the pathobiochemistry, pathobiochemistry and genetic background of atherosclerosis and kidney disease laboratories are not able to provide full explanation about the situation in individual patients. According to McNamara et al (2006) "we are still only scratching the surface, and mich more research and discovery remains to fully understand these critically important particles". As is depicted in Fig. 6 the scientist are looking on the different visible parts of the problem. The situation in clinical chemistry is even more problematic because the currently available methods are showing only the footprints of the real situation, not its essence.

Fig. 6. Scientist looking at miscellaneous aspects of the problem and a clinical chemist trying to gain some information from the footseps.
