Why Your Cholesterol Medication May Not be Effective if You are an ESRD Patient


The "statins" (medication used to lower cholesterol levels) classification of drugs is one of the most successful in recent history. One does not have to look very far to find those touting its successes. Cardiovascular Disease is by far the #1 killer of patients with Chronic Kidney Disease (CKD) and End Stage Renal Disease (ESRD). Therefore statins, with its impressive track record, is an obvious choice for CKD with Cardio Vascular Disease.

However, an extensive study found that although a statin-receiving group of ESRD patients showed a lowering of cholesterol, this failed to translate into any improved end-points in cardiovascular death or stroke. That finding has lead to the speculation that perhaps the mechanism of which cardiovascular disease occurs in dialysis patients is different from the standard "cholesterol plaque rupture" paradigm, which has become the present model.

Nevertheless, the case for statins for CKD is not completely closed and there are more recent studies that suggest there maybe some benefit to CKD using statins. In addition, another study further implied that the benefits of statins varied significantly between the stages of CKD. Within the stages of CKD however, the effects were consistent.

In the U.S. about 20% of the patients on dialysis die each year, and most of those deaths are because of Cardiovascular Disease. The fact is that the benefits of statins in CKD patients have produced contradictory results. One study showed that statins lowered the risk of premature death by 19% in patients with CKD but not on dialysis. However, it had little effect in patients on dialysis. They reduced major cardiovascular events  by 24% in CKD not on dialysis, but had little to no effect on those being dialyzed. Treatment effects on kidney transplant recipients were uncertain for both risk of premature death and major cardiovascular events.

If you are an ESRD patient suffering from Cardiovascular Disease KidneyBuzz.com recommends that you discuss this matter thoroughly with your Nephrologist and Pharmacist to satisfy any concerns you may have about the effectiveness of these medicines based upon the above results. Additionally, do not stop any medications prior to consulting your healthcare team.

Reference: Hellman, Nate, MD, PhD. "Statins in CKD: The 4D Study & More."  - Renal Fellow Network

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