Nogueira Joseph, Weir Matthew
Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA.
Clin J Am Soc Nephrol. 2007 Jul;2(4):766-85. doi: 10.2215/CJN.04131206. Epub 2007 Jun 13.
Although the risk for cardiovascular disease (CVD) is high in individuals with chronic kidney disease (CKD), there are very limited data to guide the use of lipid-lowering drugs (LLDs) in this population because the major trials of LLDs in the general population have included very few individuals with CKD. The pathophysiologic and epidemiologic differences of CVD in the CKD population suggest that the study findings derived in the general population may not be directly applicable to those with CKD, and the few trials that have been directed at patients with kidney disease have not shown clear clinical benefits of LLDs. The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) Work Group has provided consensus-based guidelines for managing dyslipidemias in individuals with CKD and after renal transplantation. Since the publication of these statements, further data have emerged and multiple studies are ongoing to define better the role of LLDs in patients with CKD. In this article, the data that are pertinent to the CKD population are reviewed, and updated recommendations for use of LLD in the CKD population are provided.
尽管慢性肾脏病（CKD）患者发生心血管疾病（CVD）的风险很高，但由于普通人群中降脂药物（LLDs）的主要试验纳入的CKD患者极少，因此指导该人群使用降脂药物的数据非常有限。CKD人群中CVD的病理生理和流行病学差异表明，普通人群的研究结果可能不适用于CKD患者，而针对肾病患者的少数试验也未显示出降脂药物有明确的临床益处。美国国家肾脏基金会肾脏病预后质量倡议（K/DOQI）工作组已提供基于共识的指南，用于管理CKD患者及肾移植后患者的血脂异常。自这些声明发表以来，又有了更多数据，多项研究正在进行，以更好地明确降脂药物在CKD患者中的作用。本文回顾了与CKD人群相关的数据，并提供了CKD人群使用降脂药物的最新建议。
