Management of Cholesterol in Patients with Chronic Kidney Disease

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Chronic kidney disease (CKD) is a common disorder with an increasing prevalence. Cardiovascular disease is the most common cause of premature death in the CKD population. Individuals with CKD have a 10-20 times greater risk of cardiac death than those without CKD. The risk of death, cardiovascular events, and hospitalization increases in a graded fashion as the GFR decreases to less than 60 mL/min/1.73 m2. As a result, the majority of patients with chronic kidney disease die of cardiovascular disease before dialysis becomes necessary.

Lowering cholesterol medications such as statins have the strongest evidencebased association with reduced cardiovascular disease risk. The Study of Heart and Renal Protection (SHARP study) was the first large-scale, long-term, placebo-controlled trial of statins for primary prevention of cardiovascular disease in patients with advanced chronic kidney disease. Treatment with the combination of simvastatin plus ezetimibe was associated with an average reduction in LDL-C of 15.3 mg/dL and a 17% reduction in majoratherosclerotic events. No difference in adverse outcomes was identified (specifically cancer andmyopathy). The clinical implication of the SHARP study is that the combination of low-dose simvastatin (20 mg) and ezetimibe (10 mg) is safe and effective, even in patients with advanced chronic kidney disease. Moreover, if high doses are avoided, statins can be used safely to reduce cardiovascular risk in patients with chronic kidney disease.

What is your current cholesterol level, and are you taking any lowering cholesterol medications?




The American Osteopathic Association, Georgia Osteopathic Medical Society, North
Carolina Osteopathic Medical Association, South Carolina Osteopathic Medical Society, and Impact Education, LLC. has great article about chronic kidney disease and a whole patient approach. For more information, please Click Here


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