Chronic kidney disease and statin eligibility

Area of Science:

• Nephrology
• Cardiology
• Public Health

Background:

• Chronic kidney disease (CKD) is a significant risk factor for atherosclerotic cardiovascular disease (ASCVD).
• Cardiovascular societies have differing recommendations on statin therapy for CKD patients.
• Discrepancies exist between US, European, and KDIGO guidelines regarding statin eligibility in CKD populations.

Purpose of the Study:

• To determine the prevalence of CKD in the US population.
• To assess statin eligibility among adults with CKD based on varying risk stratification guidelines.
• To examine the clinical implications of differing statin recommendations for CKD patients.

Main Methods:

• Utilized weighted data from the National Health and Nutrition Examination Surveys (1999-2016).
• Defined CKD based on estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m².
• Calculated 10-year ASCVD risk using pooled cohort equations at low, intermediate, and high levels.

Main Results:

• 7.5% of the US adult population had CKD (eGFR < 60 mL/min/1.73 m²).
• Among CKD patients, 46.3% had a 10-year ASCVD risk <7.5% (low risk).
• 62.5% of CKD patients were women, and 19.6% had diabetes.

Conclusions:

• A substantial proportion of CKD patients (46.3%) aged 40-75 years fall into low-risk ASCVD categories.
• These low-risk CKD patients are eligible for statin therapy per European and KDIGO guidelines but not necessarily US guidelines.
• Coronary artery calcium scoring may aid in determining statin eligibility for lower-risk CKD individuals.