CIN '2007 - 4th CONGRESS OF NEPHROLOGY IN INTERNET
Lipid Abnormalities associated with End-Stage Kidney Disease- Focus on statin therapy
Dr. Mitchell Rosner
Division of Nephology, University of Virginia Health System.Charlottesville, Virginia
Abstract
The management of lipid abnormalities in patients with end-stage renal disease (ESRD) remains controversial. Large, well designed studies investigating the effects of dyslipidemia on cardiovascular (CV) morbidity and mortality and the role of cholesterol lowering drugs in reducing mortality in ESRD patients are lacking. While it seems reasonable to suspect that dyslipidemia and its treatment in ESRD patients will affect CV morbidity and mortality similar to that in the general population, recent studies have suggested that this may not be the case. Furthermore, the pharmacokinetics of lipid lowering drugs are altered in patients with ESRD and must be considered when treating this group of patients. This article reviews the statin class of drugs used to treat dyslipidemia emphasizing their role in patients with ESRD.Comments:
- This is an excellent review of the status of our knowledge about potential benefits of statins and risks in dialysis pts. Despite the 4D results, statins should be used much more in patients on dialysis with any evidence of vascular disease, and considered in all others while we await much larget 9000 patient SHARP study of simvastatin/ezitimibe (vytorin)in CKD and dialysis pts.
Daniel Coyne
Washington Univeristy - United States of America