Considerations in the treatment of dyslipidemia associated with chronic kidney failure and renal transplantation.
In comparison to the general population, individuals with chronic kidney failure experience an increased risk for atherosclerotic cardiovascular disease attributed predominantly to pronounced abnormalities in lipid metabolism. The emerging consensus is that patients with chronic kidney failure should be treated aggressively for dyslipidemia. Statins reduce the risk of cardiovascular disease in a range of at-risk patients; this class of lipid-lowering drugs should be considered first-line treatment of dyslipidemia observed in renal disease patients. Although the statins share a common lipid-lowering effect, there are differences within this class of drugs. The statins differ in their pharmacokinetic effects, drug interaction profiles, and risk of myotoxicity. This article characterizes the dyslipidemia observed in the renal failure setting and reviews the therapeutic considerations involved in selecting among the statins. Lovastatin, simvastatin, pravastatin, fluvastatin, atorvastatin, and rosuvastatin are the available statins in the United States.
Davidson
Michael
M
Department of Preventive Cardiology, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL 60612, USA. michaeldavidson@radiantresearch.com
D000069059:Atorvastatin; D015897:Comorbidity; D050171:Dyslipidemias / Q000188:drug therapy* / Q000453:epidemiology*; D005229:Fatty Acids, Monounsaturated / Q000627:therapeutic use; D005464:Fluorobenzenes / Q000627:therapeutic use; D000077340:Fluvastatin; D006538:Heptanoic Acids / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D007211:Indoles / Q000627:therapeutic use; D007676:Kidney Failure, Chronic / Q000453:epidemiology*; D016030:Kidney Transplantation; D008148:Lovastatin / Q000627:therapeutic use; D017035:Pravastatin / Q000627:therapeutic use; D011743:Pyrimidines / Q000627:therapeutic use; D011758:Pyrroles / Q000627:therapeutic use; D000068718:Rosuvastatin Calcium; D019821:Simvastatin / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use
D005229:Fatty Acids, Monounsaturated; D005464:Fluorobenzenes; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D011743:Pyrimidines; D011758:Pyrroles; D013449:Sulfonamides; D000077340:Fluvastatin; D000068718:Rosuvastatin Calcium; D008148:Lovastatin; D000069059:Atorvastatin; D019821:Simvastatin; D017035:Pravastatin