Should statins be prescribed for primary prevention of cardiovascular disease in patients with chronic kidney disease?
Most patients with early chronic kidney disease are managed in primary care. These patients have an increased risk of cardiovascular disease; the lower the estimated glomerular filtration rate, the higher the risk.1 Patients with stages 1 to 4 of chronic kidney disease are more likely to die from cardiovascular disease than to require renal replacement therapy, and cardiovascular disease is the most common cause of death among dialysis and transplant patients.2 However, the causal pathway is unclear; conventional cardiovascular risk factors (including dyslipidaemia) may also cause kidney disease progression, but kidney disease may also cause cardiovascular disease through pathways unrelated to dyslipidaemia. The benefits of lipid lowering treatment in primary and secondary prevention of cardiovascular disease in people with preserved renal function are well established.3 4 Recent guidance from the National Institute for Health and Clinical Excellence (NICE) recommends treatment with st
