Brand New Rule Change Set To Immediately Hit The Chronic Kidney Disease Community

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The new rules that guide Lipid (fats and fatty substances used as a source of energy in your body) Management in Chronic Kidney Disease (CKD) patients has removed Low-Density Lipoprotein (LDL) cholesterol goals for those with CKD, according to Medpage. This rule change, made last month, impacts all CKD patients because they initiate cholesterol lowering treatments such as statin therapy to reduce their heightened risk of heart disease which may cause a devastating cardiovascular incident (stroke, heart attack, etc.).  

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 The change comes shortly after widespread criticism over the number of people recommended for statin drug therapy and the questionable accuracy of the new cardiovascular calculator determining CKD patients' risk of coronary complications. Now, the decision to initiate cholesterol-lowering treatment such as statins will be based on a CKD patient's unique risk of a coronary event and evidence that a medicinal therapy will help to drastically lower his/her risk, suggested Dr. Marcello Tonelli, of the University of Alberta in Edmonton.

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The new rules are nearly the same as the guidelines recommended by the  American Heart Association (AHA) and American College of Cardiology (ACC). "Statins with or without ezetimibe (lifestyle changes including diet, weight loss, and exercise) should not be started in dialysis-dependent patients with CKD," according to new guidelines. This is because toxicity of statin medication is much higher in people with CKD who are on dialysis and there is limited information determining the most appropriate statin drug regimens. Other changes include recommending that people who have already undergone a Kidney Transplant use statins. Similarly, if you have CKD and need to start dialysis then it is recommended that you maintain your current cholesterol-lowering treatments even if they include taking a statin. 

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 In summary, generally speaking those with CKD who are younger than 50 but are not yet on dialysis and have not had a Kidney Transplant should use a statin only if they have one of the following conditions: known coronary disease, diabetes, prior ischemic stroke, or an estimated 10-year risk of coronary death. Catherine Staffeld-Coit, MD, Ochsner Medical Center noted that, “Persons with renal disease are already on numerous medications and are at increased risk of drug-drug interactions." Hence, new rules for statin administration for CKD patients may limit their current pill burden, improve health outcomes and may reduce the cost of medicines. The new guidelines  also “provide a roadmap of simplicity for healthcare professionals to mitigate cardiovascular risk in their patients affected by renal disorders.” However, KidenyBuzz.com strongly advises that you NEVER stop taking your medication exactly as your doctor prescribes. These guideline changes should be thoroughly discussed with your Nephrologists BEFOREHAND. 

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References: 

Neale, Todd, Senior Staff Writer, MedPage Today. "LDL No Longer Target of Kidney Disease Lipid Management." Http://www.medpagetoday.com/. MedPage Today, LLC.

"Wider Statin Use Recommended for Chronic Kidney Disease." Http://www.pri-med.com/. Health Day.