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Markossian T, Burge N, Ling B, Schneider J, Pacold I, Bansal V, Leehey D, Stroupe K, Chang A, Kramer H. Controversies Regarding Lipid Management and Statin Use for Cardiovascular Risk Reduction in Patients With CKD. Am J Kidney Dis 2016; 67:965-77. [PMID: 26943983 DOI: 10.1053/j.ajkd.2015.12.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 12/07/2015] [Indexed: 11/11/2022]
Abstract
Adults with chronic kidney disease (CKD) are at heightened risk for dying of cardiovascular disease. Results from randomized clinical trials of statin drugs versus placebo demonstrate that statin drugs or statin plus ezetimibe reduce the absolute risk for coronary heart disease and mortality among adults with non-dialysis-dependent CKD. The Kidney Disease: Improving Global Outcomes 2013 clinical practice guideline for lipid management in CKD recommends that adults 50 years or older with non-dialysis-dependent CKD be treated with a statin or statin plus ezetimibe regardless of low-density lipoprotein cholesterol levels. However, at least 9 guidelines published during the last 5 years address lipid management for primary and secondary prevention of atherosclerotic cardiovascular disease, and not all guidelines address the utility of lipid-lowering therapy in adults with CKD. Because most patients with CKD receive most of their clinical care from non-nephrologists, differences in recommendations for lipid-lowering therapy for cardiovascular disease prevention may negatively affect the clinical care of adults with CKD and cause confusion for both patients and providers. This review addresses the identification and management of lipid levels in patients with CKD and discusses the existing controversies regarding testing and treatment of lipid levels in the CKD population.
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Affiliation(s)
- Talar Markossian
- Hines Veterans Administration Hospital, Hines, IL; Department of Medicine, Loyola University Chicago, Maywood, IL
| | | | - Benjamin Ling
- Hines Veterans Administration Hospital, Hines, IL; Department of Medicine, Loyola University Chicago, Maywood, IL
| | - Julia Schneider
- Hines Veterans Administration Hospital, Hines, IL; Department of Medicine, Loyola University Chicago, Maywood, IL
| | - Ivan Pacold
- Hines Veterans Administration Hospital, Hines, IL; Department of Medicine, Loyola University Chicago, Maywood, IL
| | - Vinod Bansal
- Department of Medicine, Loyola University Chicago, Maywood, IL
| | - David Leehey
- Hines Veterans Administration Hospital, Hines, IL; Department of Medicine, Loyola University Chicago, Maywood, IL
| | - Kevin Stroupe
- Hines Veterans Administration Hospital, Hines, IL; Department of Medicine, Loyola University Chicago, Maywood, IL
| | - Alex Chang
- Department of Medicine, Geisinger Medical Center, Danville, PA
| | - Holly Kramer
- Hines Veterans Administration Hospital, Hines, IL; Department of Medicine, Loyola University Chicago, Maywood, IL.
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