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Concepts and Controversies: Lipid Management in Patients with Chronic Kidney Disease

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Abstract

Atherosclerotic cardiovascular disease (ASCVD) remains an important contributor of morbidity and mortality in patients with chronic kidney disease (CKD). CKD is recognized as an important risk enhancer that identifies patients as candidates for more intensive low-density lipoprotein (LDL) cholesterol lowering. However, there is controversy regarding the efficacy of lipid-lowering therapy, especially in patients on dialysis. Among patients with CKD, not yet on dialysis, there is clinical trial evidence for the use of statins with or without ezetimibe to reduce ASCVD events. Newer cholesterol lowering agents have been introduced for the management of hyperlipidemia to reduce ASCVD, but these therapies have not been tested in the CKD population except in secondary analyses of patients with primarily CKD stage 3. This review summarizes the role of hyperlipidemia in ASCVD and treatment strategies for hyperlipidemia in the CKD population.

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Author notes

  1. Roy O. Mathew and Robert S. Rosenson contributed equally to this work.

Authors and Affiliations

  1. Columbia V.A. Health Care System, 6439 Garners Ferry Road, Columbia, SC, 29209, USA

    Roy O. Mathew

  2. University of South Carolina School of Medicine, Columbia, SC, USA

    Roy O. Mathew

  3. Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Robert S. Rosenson

  4. Albany Medical College and Albany Medical Center, Albany, NY, USA

    Radmila Lyubarova & Mandeep S. Sidhu

  5. University of California, San Francisco, CA, USA

    Rafia Chaudhry

  6. Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Salvatore P. Costa

  7. New York University School of Medicine, New York, NY, USA

    Sripal Bangalore

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Mathew, R.O., Rosenson, R.S., Lyubarova, R. et al. Concepts and Controversies: Lipid Management in Patients with Chronic Kidney Disease. Cardiovasc Drugs Ther 35, 479–489 (2021). https://doi.org/10.1007/s10557-020-07020-x

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