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Lipid lowering in dialysis patients with cardiovascular disease who are awaiting kidney transplantation
Author(s) -
Aziz Fahad,
Garg Neetika,
Parajuli Sandesh,
Djamali Arjang,
Stein James H.,
Mandelbrot Didier
Publication year - 2019
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13452
Subject(s) - medicine , dialysis , kidney disease , disease , intensive care medicine , adverse effect , statin , kidney transplantation , population , clinical trial , transplantation , randomized controlled trial , end stage renal disease , environmental health
Dyslipidemias are highly prevalent in chronic kidney disease, end‐stage renal disease, and kidney transplant patients. These dyslipidemias are associated with high cardiovascular risk and mortality. Many clinical trials have shown that statin therapy can significantly reduce adverse cardiovascular events in chronic kidney disease patients and kidney transplant recipients. However, three major trials did not show a benefit of statin therapy in end‐stage renal disease patients on dialysis. Major guidelines either recommend against the use of statins in patients on dialysis or provide no recommendations about statin use for this complex patient population. As a result, we suspect many patients on dialysis are not on statins, even if they have known atherosclerotic cardiovascular disease. When these patients receive kidney transplants, the risk of adverse cardiovascular events increases in the peri‐operative period. Although there are no randomized clinical trials looking at statin use in these patients, we suggest that statin use be considered in patients with a history of atherosclerotic cardiovascular disease, to potentially minimize peri‐operative cardiovascular complications. We also recommend further research to determine whether statin therapy in dialysis patients awaiting kidney transplant is associated with better survival.