I find it fascinating that doctors are aware that statins don't work on dialysis patients, even the KDIGO guidelines say not to prescribe them, and yet doctors still will go ahead and lower LDL using statins. I know I am on one ...
There are even indication that statins make things worse for dialysis patients (increasing Lp(a) ).
It's also infuriating that there are no clinical trials around this that try different drugs or approaches in the dialysis population.
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bumblebee_tuna
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Statins and CKD in general is not a good mix. You are absolutely right about no clinical trials or much research on dialysis patients. I am on a NKF committee which is talking about this right now.
I had never heard this before. I have ADPKD and have had care from nephrologists for 21 years, including 4 years on dialysis and the last 2 years and 4 months post transplant. Not one of my nephrologists ever said anything about taking statins. I've been on them since 2017 when I had stress related cardiomyopathy and they discovered I had coronary artery blockages. I would be very interested in hearing more about the NKF committee findings.
I will site some of the info out there. The problem is for everyone who say ney, there are ones who say yeh. I am not taking a chance.
Lower mortality in the statin group was consistently evident in all subgroup analyses, including patients on dialysis and low-risk young patients. In conclusion, we found that statins were associated with lower mortality in CKD patients, regardless of dialysis status or other risk factors. frontiersin.org/articles/10....
The results of this study suggest that statin use was significantly associated with a decreased risk of new-onset CKD and a slower decline in eGFR in community-dwelling older people in Shanghai, China. Meanwhile, dyslipidemia was a risk factor for CKD progression among both statin users and nonusers. ncbi.nlm.nih.gov/pmc/articl...
And this crazy "well maybe" from Clevland Clinic:
"We think some patients with chronic kidney disease should take a statin, particularly those in stages 1 through 4 (ie, not yet on dialysis1)* who have low-density lipoprotein cholesterol (LDL-C) levels higher than 100 mg/dL. However, few studies have addressed this question.
The answer is murkier in patients on dialysis. Only one study has been done in this population, and it found no benefit from statin therapy. However, we would prescribe a statin for a dialysis patient who had known coronary artery disease and an LDL-C level higher than 100 mg/dL.
Little evidence, but we would consider using statins to treat dyslipidemia in kidney patients not on dialysis" clevelandclinicmeded.com/me...
“These results ... raise the questions of whether statin therapy becomes ineffective with worsening renal disease and, if so, at which stage?” say the AURORA study team.
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