Statins for non-dialysis chronic kidney disease.

摘要

Clinical Scenario A 62-year-old man with hypertension and a glomerular filtration rate (GFR) of 40 mg per minute has a low-density lipoprotein (LDL) cholesterol level of 120 mg per dL (3.11 mmol per L). He asks if he should be on a cholesterol-lowering medication.Clinical Question Do statins improve outcomes in patients with non-dialysis chronic kidney disease (CKD)? Evidence-Based Answer When taken over a five-year period, statins significantly reduce all-cause mortality (number needed to treat [NNT] = 56), cardiovascular mortality (NNT = 86), and nonfatal cardiovascular events (NNT = 25). (Strength of Recommendation = A, based on consistent and good-quality patient-oriented evidence). In a small subset of studies spanning two to 60 months, statins reduced proteinuria, but did not slow the decline of renal function. Adverse effects of treatment are negligible.