Management of Chronic Kidney Disease Stages 1–3
Clinical Bottom Line: Risk for Mortality in Patients With CKD Stages 1–3 Treated With Statins
In patients with hyperlipidemia and decreased eGFR or creatinine clearance, statins reduced the risk for mortality, myocardial infarction, and stroke versus a control. Mortality was reduced by 20 percent (ARR = 1.6%, 7.1% vs. 8.7%; RR 0.80, 95% CI, 0.68–0.95; 8 trials, n = 13,964; high strength of evidence); the risk for myocardial infarction was reduced by 28 percent (ARR = 2.6%; 6.8% vs. 9.4%; RR = 0.72, 95% CI 0.54–0.98; 2 trials, n = 2,015 patients); and the risk for stroke was reduced by 38 percent (ARR = 0.9%; 1.4% vs. 2.3%; RR = 0.62, 95% CI 0.41–0.95; 6 trials, n = 10,369 patients). No statin trials reported clinical outcomes data for patients with albuminuria. In patients with CKD, there is low-level evidence that there is no difference in risk of mortality between treatment with a high-dose versus low-dose statin.
95% CI = 95-percent confidence interval; ARR = absolute risk reduction; CKD = chronic kidney disease; eGFR = estimated glomerular filtration rate; RR = risk ratio
Keywords: chronic kidney disease | treatment | statin | beta-blocker | outcomes | hyperlipidemia | estimated glomerular filtration rate | eGFR | creatinine
- Fink HA, Ishani A, Taylor BC, et al. Chronic Kidney Disease Stages 1–3: Screening, Monitoring, and Treatment. Comparative Effectiveness Review No. 37 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. HHSA 290-2007-10064-I). Rockville, MD: Agency for Healthcare Research and Quality; January 2012. AHRQ Publication No. 11(12)-EHC075-EF. Available at www.effectivehealthcare.ahrq.gov/ckd.cfm.
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