74
Management
4.2.8.8. Adults With Chronic Kidney Disease – Stage 3 or
Higher
COR LOE
Recommendations
1 B-R
1. In adults 40 to 75 years of age with CKD stage 3 or higher
and an LDL-C of 70 to 189 mg/dL (1.8–4.9 mmol/L),
moderate-intensity statin therapy or moderate-intensity
statin combined with ezetimibe is recommended to reduce
ASCVD risk.
1 B-R
2. In adults with CKD stage 3 or higher and clinical ASCVD,
LLT with high-intensity statin therapy, with or without
ezetimibe and/or a PCSK9 mAb, is recommended to achieve
a ≥50% reduction in LDL-C levels and a goal of LDL-C
<55 mg/dL (1.4 mmol/L) and non–HDL-C <85 mg/dL
(2.2 mmol/L) to reduce ASCVD risk.
2b C-LD
3. In adults with CKD who require maintenance hemodialysis,
it may be reasonable to continue statin therapy to reduce
the risk of ASCVD events. Treatment decisions should be
individualized with consideration of expected survival, other
comorbidities, and severity of ASCVD.
4.2.8.7. Adults With Chronic Inflammatory Diseases (CID)
4.2.8.9. Persons Living With Human Immunodeficiency Virus
(HIV)
COR LOE
Recommendation
1 B-R
1. In people living with HIV aged 40 to 75 on stable
combination antiretroviral therapy, statin therapy is
recommended to reduce risk of a first ASCVD event and
reduce the rate of coronary atherosclerosis progression.
