Management of LDL-C to reduce cardiovascular risk in nondialysis CKD patients

Statin for secondary prevention if

A patient has established atherosclerotic CVD (prior history of coronary, cerebrovascular, or peripheral arterial disease)

Statin for primary prevention if

Option A*:

All patients with GFR <60 mL/min

Patients with CKD and GFR ≥60 mL/min and age ≥50 years

Patients with CKD and GFR ≥60mL/min and other CVD risk factors (eg, diabetes, hypertension, smoking, low HDL-C, high Lp(a), etc)

Option B*:

Statin if predicted 10-year absolute risk of having a major CVD event is 7.5 to 10% or higher

Statin might be offered if risk is between 5 and 7.5%

No statin if risk is below 5%

LDL-C: low-density lipoprotein cholesterol; CKD: chronic kidney disease; CVD: cardiovascular disease; GFR: glomerular filtration rate; HDL-C: high-density lipoprotein cholesterol; Lp(a): lipoprotein(a).
* Option A and Option B reflect differing opinions among UpToDate authors and editors about criteria for initiating statin therapy in patients with nondialysis CKD.

Courtesy of Florian Kronenberg, MD.

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