Treatment of dyslipidemia in chronic kidney disease: Effectiveness and safety of statins

Table 1 Different dyslipidemic patterns at various stages of chronic kidney disease

	Patients with CKD but NOT nephrotic syndrome	Patients with nephrotic syndrome	Patients on hemodialysis	Patients on peritoneal dialysis	Transplanted patients
Total CHL	‹—› or ↑	↑↑	‹—› or ↓	↑↑	↑↑
HDL	↓	↓	↓	↓	‹—›
LDL	‹—› or ↑	↑↑↑	‹—› or ↓	↑	↑↑
TG	↑	↑↑	↑	↑↑↑	‹—› or ↑

CKD: Chronic kidney disease; CHL: Chlorophyll; HDL: High density lipoprotein; LDL: Low density lipoprotein; TG: Triglycerides.

Table 2 Cardiovascular risk factors in chronic kidney disease patients

Traditionals (Framingham-like)	Non-traditionals uremia-related
Age	Anemia
Male gender	Hyperomocysteinemia
Diabetes	Chronic inflammation
Obesity	Oxidative stress
Hypertension	Hyperparathyroidism and vascular calcifications
Smoking
Insulin levels	Accumulation of metabolic products (advanced glycation end-products, asymmetric dimethyl arginine…)?
Family history
Dyslipidemia
↑ Total cholesterol
↑ LDL
↑ Apolipoprotein a1
↑ TG
↑ Apolipoprotein B
↓ HDL
↑ Lipoprotein (a)
↑ Oxidized LDL

HDL: High density lipoprotein; LDL: Low density lipoprotein; TG: Triglycerides.

Table 3 The major side effects potentially attributable to statin therapy

Hepatic toxicity

Muscle toxicity including:

Myopathy (general term referring to any disease of muscles)

Myalgia (muscle ache or weakness without creatine kinase increase) in 1%-3%

Myositis (muscle symptoms with increase creatine kinase levels) in 0.1%

Rhabdomyolysis (muscle symptoms with increase > 10 × the upper limit of normal CK and creatinine elevation, usually associated with brown urine and urinary mioglobina in 0.0005%