“ Patients with CKD are 3 times more likely to accompany cardiovascular disease ”

Since patients with chronic kidney disease (CKD) are three times more likely to accompany cardiovascular disease than the general population, physicians should consider a lipid-lowering statin drug that may ease the burden on the kidney. , said an expert.

To celebrate World Kidney Day on March 11, Professor Kim Hyo-sang from the Department of Nephrology at Asan Medical Center in Seoul focused on the management of cardiovascular disease, a major complication of CRF.

The World Kidney Day Steering Committee declared 2021 the year of ‘Living Well with Kidney Disease’, stressing the importance of managing irreversible CRF in a variety of ways so that patients do not experience deterioration. symptoms and lead a healthy daily life without the risk of complications.

It is especially important to prevent cardiovascular disease in patients with chronic CRF, as they could die if coronary artery disease or stroke occurs before end stage renal disease.

According to the KNOW-KIDNEY study by the Korea Disease Control and Prevention Agency (KCDA), 0.8 percent of stage 1 kidney disease patients in Korea had cardiovascular disease. The figure rose to 9.8 percent in patients with stage 4 kidney disease. As the stage of kidney disease progressed, the proportion of cardiovascular disease increased, the study showed.

Doctors are increasingly interested in statin class drugs used to manage cardiovascular disease in patients with CRF.

The Kidney Disease Improving Global Outcomes (KDIGO) guidelines recommend statin therapy in all patients with CRF aged 50 years or older or those younger than 50 years of age with diabetes, or patients with a history of coronary artery disease or stroke, or patients with a risk of death or non-fatal myocardial infarction from coronary heart disease for the next 10 years exceeding 10 percent.

A 2016 Korean cohort study on outcomes in patients with CRF (KNOW-CKD) showed that more than one in two patients in Korea had used statins between 2011 and 2015.

“One study showed that local adults with CRF are about three times more likely to have cardiovascular disease than the general population,” Kim said. “If there is a problem with kidney function when prescribing a statin for the management of cardiovascular disease, doctors should consider choosing a statin that can relieve the kidney load.”

A meta-analysis of 57 randomized, controlled clinical trials of statins in 143,888 domestic patients, excluding those on dialysis, demonstrated that statins of different types and doses induced significant differences in estimated glomerular filtration rate ( EGFR), an indicator of kidney function.

The Korean Lipids and Atherosclerosis Society (KSoLA) recommends using statins that are primarily metabolized in the liver and less excreted in the kidneys when treating stage 3 or higher CKD.

Atorvastatin is one of the statins excreted in the liver, not the kidneys. Atorvastatin does not require dose adjustment because renal impairment does not affect the plasma concentration of atorvastatin or the effect of lowering LDL-C.

“Since statin therapy is very beneficial in patients with renal failure at high risk for cardiovascular disease, patients should continue treatment by consulting a doctor rather than arbitrarily stopping it due to the kidney load,” he said. Kim said.