[Statins: what is their place in the treatment of chronic kidney insufficiency?]
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Published on: November 17, 2018
Belén Ponte1, Vincent Bourquin, Catherine Stoermann-Chopard
1Service de néphrologie, Département de médecine interne, HUG, 1211 Genève.
Insights
Dyslipidemia is common in chronic kidney disease (CKD) patients, increasing cardiovascular risks. Lipid-lowering drugs are recommended for secondary prevention in all CKD stages.
Area of Science:
- Nephrology
- Cardiology
- Clinical Pharmacology
Context:
- Dyslipidemia is a significant issue in chronic kidney disease (CKD) patients.
- CKD patients face elevated risks of cardiovascular morbidity and mortality.
- The typical lipid profile in CKD includes high triglycerides, atherogenic lipoproteins, and low HDL cholesterol.
Purpose:
- To review the role of statins in managing dyslipidemia in CKD patients.
- To assess the efficacy and safety of lipid-lowering therapies in different stages of CKD.
- To provide recommendations for lipid management in CKD.
Summary:
- Statins are safe for CKD patients, similar to the general population.
- Evidence suggests statins reduce cardiovascular mortality in predialysis CKD patients for secondary prevention.
- Benefits in dialysis patients and primary prevention require further investigation.
Impact:
- Highlights the cardiovascular risks associated with dyslipidemia in CKD.
- Emphasizes the safety and potential benefits of statins in CKD management.
- Suggests a proactive approach to lipid management in CKD patients, particularly for secondary prevention.
Abstract:
Dyslipidemia is highly prevalent in patients with chronic kidney disease (CKD), contributing to their high cardiovascular morbidity/ mortality risk and kidney damage. The lipid profile of patients with CKD commonly shows elevation of triglycerides, accumulation of atherogenic lipoproteins and decrease of HDL cholesterol. Statins are as safe and secure in CKD patients as in the general population. Used as secondary prevention in predialysis patients they seem to reduce cardiovascular mortality, but such beneficence has not been confirmed in dialysis patients. Data are still lacking in primary prevention. Ongoing studies may help to draw more precise recommendations. Meanwhile, we suggest starting lipid lowering drugs as secondary prevention in all patients at all stages of CKD.
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