Children and adolescents undergoing kidney transplantation have an inordinately higher rate of early onset coronary artery disease (CAD) compared to age- and gender-matched controls. As allograft and patient survival rates have improved pediatric kidney transplant recipients are living longer and developing associated cardiac risk factors. As a result, CAD is the most common cause of death in this patient population. Coronary artery disease (CAD), also known as ischemic heart disease (IHD), atherosclerotic heart disease, atherosclerotic cardiovascular disease, and coronary heart disease, is a group of diseases that includes: stable angina, unstable angina, myocardial infarction, and sudden coronary death. It is within the group of cardiovascular diseases of which it is the most common type.