CV Risk Factors Undertreated in High-Risk CKD Patients

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LAS VEGAS—Modifiable cardiovascular (CV) risk factors remain undertreated in a very high-risk population of patients with chronic kidney disease (CKD), new findings presented at the National Kidney Foundation's Spring Clinical Meetings suggest.

Among patients with CKD and concurrent coronary heart disease (CHD), only 51.1% used lipid-lowering agents. The proportion increased slightly as renal impairment progressed, from 42.9% in patients with CKD stage 1 to 54.6% in those with CKD stage IV. In addition, the overall proportion of these patients achieved the low-density lipoprotein (LDL)-cholesterol goal of less than 100 mg/dL was only 54%.

The overall use of antihypertensive use in patients with both CKD and CHD was 69.2%. Nevertheless, the overall proportion of patients who met their blood pressure (BP) goal was 45.8%.

Among subjects with both CKD and diabetes, 70.8% of subjects reported using BP-lowering medications, but the overall proportion of patients who met their BP goal was only 36.5%. The overall use of lipid-lowering medications in these patients was 41.5%, with the use of these drugs increasing along with renal impairment, from 37.3% in patients with stage 1 CKD to 49.5% of those with stage IV CKD. Only 45.6% of these patients achieved an LDL-C goal of less than 100 mg/dL.

“These findings highlight an unmet medical need in CKD care and the potential for intensive risk factor modification to maximize CV event reduction in patients at very high for CHD,” the researchers concluded.

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