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Statin and antiplatelet drugs in CKD

Authoring team

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:


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