Related Experiment Video
Updated: Mar 15, 2026
LDL Cholesterol Uptake Assay Using Live Cell Imaging Analysis with Cell Health Monitoring
Published on: November 17, 2018
Eligibility for Statin Treatment in Korean Subjects with Reduced Renal Function: An Observational Study
Byung Sub Moon1, Jongho Kim1, Ji Hyun Kim1
1Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
Insights
Statin eligibility increases with declining kidney function in Korean adults. The ACC/AHA guidelines better align with KDIGO recommendations for statin use in chronic kidney disease (CKD) patients compared to ATP III.
Area of Science:
- Cardiology
- Nephrology
- Public Health
Background:
- Cardiovascular disease (CVD) risk assessment is crucial for statin therapy.
- Renal dysfunction is a significant comorbidity affecting CVD risk and treatment eligibility.
- Understanding statin eligibility across different stages of kidney disease is vital for primary prevention.
Purpose of the Study:
- To examine the association between renal dysfunction and statin eligibility in Korean adults.
- To compare the performance of Adult Treatment Panel (ATP) III and American College of Cardiology (ACC)/American Heart Association (AHA) guidelines in identifying statin-eligible individuals with varying degrees of kidney function.
Main Methods:
- Utilized data from 18,746 participants in the Kangbuk Samsung Health Study (2011-2012).
- Categorized participants into three groups based on estimated glomerular filtration rate (eGFR): ≥90, 60-89, and <60 mL/min/1.73 m².
- Assessed statin eligibility using ATP III and ACC/AHA guidelines, calculating 10-year atherosclerotic cardiovascular disease (ASCVD) risk with Framingham Risk Score (FRS) and Pooled Cohort Equation (PCE).
Main Results:
- 18.9% and 21.5% of subjects were statin-eligible per ATP III and ACC/AHA guidelines, respectively.
- Statin eligibility increased significantly as renal function declined across both guideline sets.
- ACC/AHA guidelines demonstrated superior agreement (κ=0.689) with Kidney Disease Improving Global Outcomes (KDIGO) recommendations for chronic kidney disease (CKD) stages 3-5 compared to ATP III (κ=0.531).
- ASCVD risk scores (FRS and PCE) significantly increased with worsening renal function.
Conclusions:
- Worsening renal function is associated with a higher proportion of statin-eligible individuals in the Korean population.
- The ACC/AHA guidelines offer better concordance with KDIGO recommendations for statin eligibility in CKD patients than the ATP III guidelines.
Background:
The purpose of this study was to investigate the relationship between statin eligibility and the degree of renal dysfunction using the Adult Treatment Panel (ATP) III and the American College of Cardiology (ACC)/American Heart Association (AHA) guidelines in Korean adults.
Methods:
Renal function was assessed in 18,746 participants of the Kangbuk Samsung Health Study from January 2011 to December 2012. Subjects were divided into three groups according to estimated glomerular filtration rate (eGFR): stage 1, eGFR ≥90 mL/min/1.73 m²; stage 2, eGFR 60 to 89 mL/min/1.73 m²; and stages 3 to 5, eGFR <60 mL/min/1.73 m². Statin eligibility in these groups was determined using the ATP III and ACC/AHA guidelines, and the risk for 10-year atherosclerotic cardiovascular disease (ASCVD) was calculated using the Framingham Risk Score (FRS) and Pooled Cohort Equation (PCE).
Results:
There were 3,546 (18.9%) and 4,048 (21.5%) statin-eligible subjects according to ATP III and ACC/AHA guidelines, respectively. The proportion of statin-eligible subjects increased as renal function deteriorated. Statin eligibility by the ACC/AHA guidelines showed better agreement with the Kidney Disease Improving Global Outcomes (KDIGO) recommendations compared to the ATP III guidelines in subjects with stage 3 to 5 chronic kidney disease (CKD) (κ value, 0.689 vs. 0.531). When the 10-year ASCVD risk was assessed using the FRS and PCE, the mean risk calculated by both equations significantly increased as renal function declined.
Conclusions:
The proportion of statin-eligible subjects significantly increased according to worsening renal function in this Korean cohort. ACC/AHA guideline showed better agreement for statin eligibility with that recommended by KDIGO guideline compared to ATP III in subjects with CKD.
Related Concept Videos
01:20Lipid-Lowering Drugs: Statins and Miscellaneous Agents
01:11Renal Failure: Dose Adjustments
Reduced renal clearance and elimination rate are common outcomes of renal impairment. These alterations lead to a prolonged elimination half-life and an altered apparent volume of distribution for drugs. As a result, dosage adjustments are typically necessary to maintain optimal drug levels in the body.
However, dosage adjustments...
01:28Drug Dosing in Renal Diseases: Estimation of Glomerular Filtration Rate Based on Serum Creatinine Concentration
01:28Chronic Kidney Disease III: Interprofessional Care
01:25Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant
01:18Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Metabolism