Guidelines from the Kidney Disease: Developing Global Guidelines (KDIGO) organization call for wider statin use among patients with chronic kidney disease (CKD). KDIGO updated its clinical practice guidelines for lipid management in patients with CKD earlier in 2013. A synopsis of these guidelines being published in Annals of Internal Medicine focuses on eight specific recommendations relating to pharmacological cholesterol-lowering among adult patients with CKD.
Patients recommended for statin use include adults aged 50 or older with eGFR < 60 ml/min/1.73m2 but not treated with dialysis or kidney transplantation. However, patients already taking a statin at the time of dialysis may continue to do so.
Statin use is also recommended for kidney transplant recipients, as their risk for coronary events is markedly elevated.
Younger adults (18 - 49 years) with eGFR < 60 ml/min/1.73m2 but not treated with dialysis or kidney transplantation should be treated with statins if they are known to have coronary disease, diabetes, prior ischemic stroke, or an estimated 10-year incidence of coronary death or non-fatal myocardial infarction of more than 10 percent.
Evidence suggests that LDL-C is not an adequate assessment of cardiovascular risk in people with CKD. Adults with newly identified CKD should be evaluated with a lipid profile, but follow-up measurement is not required.
The complete synopsis is available here.