Lege Artis Medicinae

[The role of antilipidaemic therapy in chronic kidney disease]

CSÁSZÁR Albert

FEBRUARY 20, 2012

Lege Artis Medicinae - 2012;22(02)

[In chronic kidney disease (CKD), the risk of cardiovascular mortality is remarkably high, which is partly due to lipid alterations. The results with statin treatment in cardiovascular prevention studies and in CKD, and their metaanalysis show that antilipidaemic therapy decreases overall and cardiovascular mortality in the predialysed state. On the basis of the new study SHARP, coadministration of simvastatin plus ezetimib also significantly reduces the number of atherosclerotic events in predialysed CKD (this was the first positive hard-endpoint result regarding the combination), thus it can be considered as an alternative. A large-scale metaanalysis of two earlier studies assessing the dialysed patients and patients of the SHARP study who received only dialysis indicated that antilipidaemic therapy was successful, as the number of nonfatal myocardial infarctions and coronary revascularisation interventions have been significantly reduced. These new results also show that in patients who need dialysis, the efficiency of statin or statin plus ezetimib therapy is decreased compared to predialysed state - owing to the partly different pathomechanism -, but this antilipidaemic therapy - especially in those with a high cardiovascular risk - can reduce the incidence of cardiovascular events.]

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