New guidelines for lipid management in chronic kidney disease (CKD) recommend wider statin use, according to a clinical practice guideline published online Dec. 10 in the Annals of Internal Medicine.
Marcello Tonelli, M.D., from the University of Alberta in Edmonton, Canada, and colleagues reviewed and graded the evidence and developed a clinical practice guideline on lipid management and treatment of all adults and children with CKD.
The guidelines include 13 recommendations, with eight recommendations relating to assessment of lipid status and treatment with statin-based regimens. For adults ≥50 years with an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m², not treated with chronic dialysis or kidney transplantation, treatment with a statin or statin/ezetimibe combination is recommended. Statin treatment is recommended for adults aged ≥50 years with CKD and eGFR ≥60 mL/min/1.73 m².
Younger adults (18 to 49 years) with CKD who are not treated with chronic dialysis or kidney transplantation should receive statin treatment if they have at least one of the following: known coronary disease, diabetes mellitus, prior ischemic stroke, or >10 percent estimated 10-year incidence of coronary death or non-fatal myocardial infarction. Statins or statin/ezetimibe combinations should not be initiated for adults with dialysis-dependent CKD, although treatment can be continued for those receiving it at dialysis initiation. Adult kidney transplant recipients should also be treated with a statin. Adults with newly identified CKD should be evaluated with a lipid profile, but follow-up measurements are not required.
“Within the guideline, implications for clinical practice, future research, and implementation in international settings are highlighted,” the authors write.
Two authors disclosed financial ties to the pharmaceutical industry.