Review Article

American Journal of Cardiovascular Drugs

, Volume 13, Issue 6, pp 385-398

HMG-CoA Reductase Inhibitors in Chronic Kidney Disease

  • A. OlyaeiAffiliated withDivision of Nephrology and Hypertension, Oregon State University and Oregon Health and Sciences University Email author 
  • , J. L. StefflAffiliated withDivision of Nephrology and Hypertension, Oregon State University and Oregon Health and Sciences University
  • , J. MacLaughlanAffiliated withDivision of Nephrology and Hypertension, Oregon State University and Oregon Health and Sciences University
  • , M. TrabolsiAffiliated withUniversity of Illinois at Chicago/Advocate Christ Medical Center, Internal Medicine Residency Program
  • , S. P. QuadriAffiliated withUniversity of Illinois at Chicago/Advocate Christ Medical Center, Internal Medicine Residency Program
  • , I. AbbasiAffiliated withUniversity of Illinois at Chicago/School of Public Health
  • , E. LermaAffiliated withDivision of Nephrology, Department of Medicine, University of Illinois at Chicago College of Medicine/Advocate Christ Medical Center Associates in Nephrology

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Abstract

The incidence of chronic kidney disease (CKD) is on the rise in the USA. Cardiovascular events are the leading cause of death in this patient population, therefore reducing the risk of these events has become a major focus. The aim of this review is to assess current literature on the use of statins in CKD and end-stage renal disease. Cholesterol reduction is important in preventing the development and progression of coronary heart disease and its negative effects. Statins have been widely studied and proven to reduce cardiovascular risk in the general population. The information gained from trials has been extrapolated to special populations, including CKD, despite these patients often being excluded. However, recent studies have begun to focus on CKD, hemodialysis, and transplant patients and the use of cholesterol-lowering agents and the potential association with decreased cardiovascular events. In addition, due to the unique pharmacokinetic and pharmacodynamic changes that occur in these patients, choosing the appropriate cholesterol-lowering agent becomes important for both safety and efficacy. The complexity of CKD patients is an important consideration when choosing cholesterol-lowering medication. Patients with CKD are often on medications that may interact with many of the cholesterol-lowering agents. Ensuring drug interactions are minimized is essential to the prevention of adverse events from the medications.