title: Critical appraisal of the SHARP trial: the results may be dull.
abstract: OBJECTIVE
  The goal of this commentary was to provide a critical analysis of the SHARP (Study of Heart and Renal Protection) trial. Published in 2011, this study has been used by clinicians to justify the prescribing of statins (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors) ±ezetimibe in patients with chronic kidney disease.
  
  
  METHODS
  We conducted a critical appraisal of the SHARP trial and associated documents (ie, US Food and Drug Administration review, SHARP protocol). We also examined background reviews and studies conducted before the SHARP trial to provide additional context and background.
  
  
  RESULTS
  Our analysis provides clinicians with important criticisms of the SHARP trial, which suggest questionable clinical benefit to lipid-lowering therapy in patients with chronic kidney disease.
  
  
  CONCLUSIONS
  Our hope is that clinicians limit the broad prescription of statins (±ezetimibe) in all patients with chronic kidney disease (both dialysis and nondialysis) unless there is a valid reason for statin therapy (eg, existing cardiovascular disease).
authors.affiliation: Vancouver General Hospital, Vancouver, BC, Canada. Electronic address: megan.harbin@vch.ca.
authors.forename: Megan
authors.initials: M
authors.lastname: Harbin
authors.affiliation: Kelowna General Hospital, Kelowna, BC, Canada.
authors.forename: Anthony
authors.initials: A
authors.lastname: Amadio
authors.affiliation: Lower Mainland Pharmacy Services, Vancouver, BC, Canada.
authors.forename: Aaron
authors.initials: A
authors.lastname: Tejani
mesh_terms: D002318:Cardiovascular Diseases / Q000517:prevention & control*; D000069438:Ezetimibe / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy*; D014481:United States
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069438:Ezetimibe
keywords: chronic kidney disease; statins; ±ezetimibe