Are you on a statin medication? Statins, such as atorvastatin, rosuvastatin, simvastatin, and pravastatin, are common cholesterol-lowering drugs often prescribed to people with chronic kidney disease (CKD). Research shows that, when dosed properly, statins can have significant health benefits for CKD patients. Learn more about statin medications, their benefits in CKD, and if physicians are prescribing them properly.* 

What are statin medications?

Statins are prescribed to help lower lipid (such as cholesterol and triglyceride) levels in the blood, and decrease the risk of heart attacks and strokes. In CKD, kidney dysfunction puts patients at an increased risk for elevated blood lipids and abnormal heart conditions. Statins reduce the amount of cholesterol made by the liver, and help remove excess cholesterol from the blood. They can also reduce inflammation in the artery walls that causes blockages. Studies have shown that statins may reduce the risk of heart attack, stroke, and even death from heart disease.

Which CKD patients should take statins?

In 2013, the organization Kidney Disease: Improving Global Outcomes (KDIGO) gathered data from multiple studies and released statin drug recommendations for CKD patients. These recommendations included prescribing statins for:

• All CKD patients over the age of 50 years old and in CKD stages 1 through 4 
• CKD patients aged 18-49, in stages 1 through 4, with diabetes, heart disease, or a prior stroke
• Post-kidney transplant patients 

For dialysis patients, there was no benefit found in starting a statin once on dialysis. On the other hand, there was no recommendation to stop a statin for dialysis patients who are already taking one.

There are also specific recommendations for initial statin doses, as well as for adjusting dosages based on changes in care. 

Are statins being prescribed as recommended?

Using health records of patients between 18 and 89 years of age, a more recent study investigated whether doctors followed dosing recommendations for rosuvastatin. Their findings suggested that 67.6% (25 of 37) of patients did not have their statin dosage appropriately adjusted for renal function. 

While the researchers did not deeply investigate the doctors’ barriers to following dosage recommendations, they do believe that more collaboration between doctors and clinical pharmacists may benefit patients. Clinical pharmacists could provide more specific drug knowledge to help doctors in initiating, titrating, and adjusting statin medications. 

*Jacobs, S. (2022, June 7). High-Intensity Statin Recommended in Patients With Atherosclerotic Cardiovascular Disease and Comorbid Nondialysis Chronic Kidney Disease. The Cardiology Advisor. https://www.thecardiologyadvisor.com/home/conference-highlights/nla-2022-meeting-highlights/statin-prescribing-suboptimal-in-ascvd-with-nondialysis-ckd/