OBJECTIVE: To study the relationship between hyperlipidemia and pathologic renal changes in children with the primary nephrotic syndrome(NS). METHODS: Forty five children with no minimal change glomerulopathy (NMCD) (clinical type: steroidresistent NS) and 10 children with minimal change glomerulopathy (MCD) (clinical type: steroid sensitive NS) were compared with 80 healthy children. Seven lipoprotein metabolism parameters including serum total cholestero1 (TC), triglyceride (TG), highdensity lipoprotein cholesterol (HDL-C), lowdensity lipoprotein cholesterol (LDL-C), apolipoprotein AI (ApoAI), apolipoprotein B (ApoB) and lipoprotein (a) ［Lp (a)］ were detected using enzyme methods. RESULTS: After the treatment of the children with prednisone for 2 months, lipoprotein metabolism parameters remained significantly higher in the NMCD group compared to the controls: serum TC ［(6.54±4.33) mmol/L (NMCD) vs (3.94±0.67) mmol/L (control)］, TG ［(3.45±2.56) mmol/L vs (0.91±0.32) mmol/L］, HDL-C ［(1.62±0.79) mmol/L vs (1.31±0.32) mmol/L］, LDL-C［ (2.69±0.87) mmol/L vs (2.15±0.58) mmol/L］, ApoAI　［(1.51±0.54) g/L vs (1.30±0.58) g/L］, ApoB ［(1.45±0.54) g/L vs (0.67±0.16) g/L］, Lp(a) ［(360.6±179.4) g/L vs (162.5±128.5) g/L］ (P<0.05 or 0.01). In contrast, all abnormal lipoprotein metabolism parameters in the MCD cases recovered after prednisone treatment. CONCLUSIONS: There are obvious and long-term abnormialities of serum lipoprotein metabolism parameters in the NMCD group. NMCD cases should be treated with lipidlowering drugs early, while MCD cases should not be treated with lipid lowering drugs.