Statin and antiplatelet drugs in CKD

Statins and antiplatelet drugs

• statin:
  • offer atorvastatin 20 mg for the primary or secondary prevention of CVD to people with CKD
    • increase the dose if a greater than 40% reduction in non-HDL cholesterol is not achieved and eGFR is 30 ml/min/1.73 m2 or more
    • agree the use of higher doses with a renal specialist if eGFR is less than 30 ml/min/ 1.73 m2
  • offer statins to people with CKD for the secondary prevention of CVD irrespective of baseline lipid values
    
    
• antiplatelet drugs
  • offer antiplatelet drugs to people with CKD for the secondary prevention of CVD. CKD is not a contraindication to the use of low dose aspirin but clinicians should be aware of the increased risk of minor bleeding in people with CKD given multiple antiplatelet drugs
    • consider apixaban in preference to warfarin in people with a confirmed eGFR of 30-50 ml/min/1.73 m2 and non-valvular atrial fibrillation who have 1 or more of the following risk factors:
      • prior stroke or transient ischaemic attack
      • age 75 years or older
      • hypertension
      • diabetes mellitus
      • symptomatic heart failure
        
        
• there is insufficient evidence to recommend the routine use of drugs to lower uric acid in people with CKD who have asymptomatic hyperuricaemia
  
  

Reference:

• (1) NICE (July 2014). Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease
• (2) NICE (July 2014). Chronic Kidney Disease - Early identification and management of chronic kidney disease in adults in primary and secondary care