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Cardiovascular Risk Stratification and Appropriate Use of Statins in Patients with Chronic Kidney Disease According to Different Strategies

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Abstract

Introduction

Different strategies were proposed to stratify cardiovascular risk and assess the appropriate use of statins in patients with chronic kidney disease (CKD).

Aim

(1) To apply two strategies on the management of lipids in patients with CKD, analyzing what proportion of patients received lipid-lowering treatment and how many patients without statin therapy would be candidates for receiving them; (2) to identify how many patients achieve the lipid goals.

Methods

A cross-sectional study was performed. Patients aged between 18 to 70 years and CKD with an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 (without hemodialysis) were included. The indications for statin therapy according to 2019 ESC/EAS and 2013 KDIGO guidelines were analyzed as well as the achievement of LDL-C goals.

Results

A total of 300 patients were included. According to ESC/EAS guidelines, 62.3 and 37.7% of the population was classified at high or very high cardiovascular risk. In total, 52% of patients received statins. Applying the 2013 KDIGO and the 2019 ESC/EAS guidelines, 92.4 and 95.8% of the population without lipid-lowering treatment were eligible for statin therapy, respectively. Globally, only 9.1 and 10.6% of the patients with high or very high risk achieved the suggested lipid goals.

Conclusion

A large proportion of patients with CKD showed considerable cardiovascular risk and were eligible for statin therapy according to the two strategies evaluated. However, observed statin use was deficient and current lipid goals were not achieved in most cases.

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Authors and Affiliations

  1. Cardiology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Buenos Aires, Argentina

    Leandro Barbagelata, Walter Masson, Emiliano Rossi, Martin Lee, Juan Lagoria & Rodolfo Pizarro

  2. Nefrology Department, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199ABB, Buenos Aires, Argentina

    Manuel Vilas & Guillermo Rosa Diez

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  1. Leandro Barbagelata
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  2. Walter Masson
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Contributions

LB, WM, GRD, and ER participated in the conception and design of the research. ML, JIL and MV participated in the data collection. The interpretation of the data and the statistical analysis was done by WM, RP, ER, GRD, MV and LB. WM and LB drafted the manuscript. All authors performed a critical review of the final document. All authors have read and agreed to the published version of the manuscript.

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Correspondence to Leandro Barbagelata.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

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The authors did not receive support from any organization for the submitted work.

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Barbagelata, L., Masson, W., Rossi, E. et al. Cardiovascular Risk Stratification and Appropriate Use of Statins in Patients with Chronic Kidney Disease According to Different Strategies. High Blood Press Cardiovasc Prev 29, 435–443 (2022). https://doi.org/10.1007/s40292-022-00531-8

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