Division of Nephrology and Hypertension, Oregon State University and Oregon Health and Sciences University, 3181 SW Sam Jackson Park Road, Mail Code CR9-4, Portland, OR, 97201, USA,
Am J Cardiovasc Drugs. 2013 Dec;13(6):385-98. doi: 10.1007/s40256-013-0041-4.
The incidence of chronic kidney disease (CKD) is on the rise in the USA. Cardiovascular events are the leading cause of death in this patient population, therefore reducing the risk of these events has become a major focus. The aim of this review is to assess current literature on the use of statins in CKD and end-stage renal disease. Cholesterol reduction is important in preventing the development and progression of coronary heart disease and its negative effects. Statins have been widely studied and proven to reduce cardiovascular risk in the general population. The information gained from trials has been extrapolated to special populations, including CKD, despite these patients often being excluded. However, recent studies have begun to focus on CKD, hemodialysis, and transplant patients and the use of cholesterol-lowering agents and the potential association with decreased cardiovascular events. In addition, due to the unique pharmacokinetic and pharmacodynamic changes that occur in these patients, choosing the appropriate cholesterol-lowering agent becomes important for both safety and efficacy. The complexity of CKD patients is an important consideration when choosing cholesterol-lowering medication. Patients with CKD are often on medications that may interact with many of the cholesterol-lowering agents. Ensuring drug interactions are minimized is essential to the prevention of adverse events from the medications.
美国慢性肾脏病 (CKD) 的发病率呈上升趋势。心血管事件是该患者人群的主要死亡原因，因此降低这些事件的风险已成为主要关注点。本综述旨在评估目前关于他汀类药物在 CKD 和终末期肾病中的应用的文献。降低胆固醇对于预防冠心病的发生和发展及其负面影响非常重要。他汀类药物已被广泛研究并已证明可降低普通人群的心血管风险。尽管这些患者经常被排除在外，但从试验中获得的信息已被推断用于特殊人群，包括 CKD。然而，最近的研究开始关注 CKD、血液透析和移植患者以及使用降胆固醇药物和潜在的与降低心血管事件的关联。此外，由于这些患者中发生独特的药代动力学和药效学变化，选择合适的降胆固醇药物对于安全性和疗效都很重要。CKD 患者的复杂性是选择降胆固醇药物时需要考虑的重要因素。CKD 患者通常服用可能与许多降胆固醇药物相互作用的药物。确保药物相互作用最小化对于预防药物的不良反应至关重要。
