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4.5.4 Adults With CKD
COR LOE
Recommendations
IIa B-R 1. In adults 40 to 75 years of age with LDL-C 70 to 189 mg/
dL (1.7 to 4.8 mmol/L) who are at 10-year ASCVD risk of
7.5% or higher, CKD not treated with dialysis or kidney
transplantation is a risk-enhancing factor and initiation of
a moderate-intensity statin or moderate- intensity statins
combined with ezetimibe can be useful.
IIb C-LD 2. In adults with advanced kidney disease that requires dialysis
treatment who are currently on LDL-lowering therapy with a
statin, it may be reasonable to continue the statin.
III: No
Benefit
B-R 3. In adults with advanced kidney disease who require dialysis
treatment, initiation of a statin is NOT recommended.
4.5.5. Adults With Chronic Inflammatory Disorders and HIV
COR LOE
Recommendations
IIa B-NR 1. In adults 40 to 75 years of age with LDL-C 70 to 189 mg/dL
(1.7 to 4.8 mmol/L) who have a 10-year ASCVD risk of
7.5% or higher, chronic inflammatory disorders and HIV are
risk-enhancing factors and in risk discussion favor moderate-
intensity statin therapy or high-intensity statin therapy.
IIa B-NR 2. In patients with chronic inflammatory disorders or HIV, a
fasting lipid profile and assessment of ASCVD risk factors
can be useful as (a) a guide to benefit of statin therapy and
(b) for monitoring or adjusting lipid-lowering drug therapy
before and 4 weeks to 12 weeks after starting inflammatory
disease-modifying therapy or antiretroviral therapy.
IIa B-NR 3. In adults with RA who undergo ASCVD risk assessment
with measurement of a lipid profile, it can be useful to
recheck lipid values and other major ASCVD risk factors 2
to 4 months after the patient's inflammatory disease has been
controlled.
