Elsevier

Kidney International

Volume 85, Issue 6, June 2014, Pages 1303-1309
Kidney International

Review
KDIGO Clinical Practice Guideline for Lipid Management in CKD: summary of recommendation statements and clinical approach to the patient

https://doi.org/10.1038/ki.2014.31Get rights and content
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The Kidney Disease: Improving Global Outcomes (KDIGO) organization developed clinical practice guidelines on lipid management for all adults and children with chronic kidney disease (CKD). Thirteen recommendations were obtained from the available evidence outlining a three-step management including assessment in all, treatment in many, and follow-up measurements in few. A key element is the recommendation of statin or statin/ezetimibe treatment in adults aged ≥50 years with estimated glomerular filtration rate (eGFR) <60 ml/min per 1.73 m2 but not treated with chronic dialysis or kidney transplantation. In dialysis patients, the magnitude of any relative reduction in risk appears to be substantially smaller than in earlier stages of CKD and initiation of statin treatment is not recommended for most prevalent hemodialysis patients. In the past, clinical practice guidelines suggested the use of targets for LDL cholesterol, which require repeated measurements. Treatment escalation with higher doses of statin would be a consequence when LDL cholesterol targets are not met. The KDIGO Work Group did not recommend this strategy because higher doses of statins have not been proven to be safe in the setting of CKD. Since LDL cholesterol levels do not necessarily suggest the need to increase statin doses, follow-up measurement of lipid levels is not recommended.

Keywords

cholesterol
chronic kidney disease
dyslipidemia
evidence-based recommendation
systematic review
triglyceride

Cited by (0)

MT, Advisor/Consultant: Merck (honoraria donated to charity). CW, Speaker: Astellas-Pfizer (Japan); Merck & Merck Sharp Dohme.

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Members of the Kidney Disease: Improving Global Outcomes Lipid Guideline Development Work Group were: Alan Cass, Amit X. Garg, Hallvard Holdaas, Alan G. Jardine, Lixin Jiang, Florian Kronenberg, Rulan S. Parekh, Tetsuo Shoji, and Robert J. Walker. Also see the Appendix.