Editorials

Statins for people with kidney disease

BMJ 2008; 336 doi: https://doi.org/10.1136/bmj.39483.665139.80 (Published 20 March 2008) Cite this as: BMJ 2008;336:624
  1. Catherine M Clase, associate professor of medicine
  1. 1McMaster University, Hamilton, ON L8N 1Y2
  1. clase@mcmaster.ca

    Criteria for treatment should be the same as for people with normal kidney function

    In the accompanying paper, Strippoli and colleagues report a meta-analysis of the benefits and harms of statins in patients with chronic kidney disease. They report outcomes for people with low glomerular filtration rate, those on dialysis, and those with kidney transplants.1

    Chronic kidney disease (glomerular filtration rate < 60 ml/min/1.73 m2 or urine abnormalities) and cardiovascular disease often coexist; chronic kidney disease also predicts cardiovascular events. A recent meta-analysis reported that low glomerular filtration rate was associated with an unadjusted relative risk of 2.5 (95% confidence interval 1.4 to 4.3) for cardiovascular events.2 In adjusted analyses, some of this effect is explained by the high prevalence of traditional risk factors for cardiovascular disease in people with low glomerular filtration rate or albuminuria.3 4 However, non-traditional risk factors such as anaemia (which in patients on dialysis predicts left ventricular hypertrophy, systolic dysfunction, and congestive heart failure5) and factors favouring vascular calcification (which in patients on dialysis predicts death6) may contribute …

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