Therapeutic considerations for the use of statin therapy in chronic renal disease

This review presents an evidence-based analysis of the use of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) in patients with chronic renal disease. It considers the characteristics and incidence of dyslipidaemia among specific patient types and describes the available data concerning the ability of statin therapy to regulate dyslipidaemia in the renal disease population as well as early results for an anti-inflammatory effect in this group. The clinical impact of statins in terms of reduced morbidity and mortality is also discussed. The relative merits of different statin agents are reviewed in terms of efficacy and safety, together with the role of aggressive intervention as compared with standard approaches to care. Finally, a proposed algorithm for the initiation and monitoring of statin therapy in chronic renal disease patients is presented. Copyright (C) 2003 S. Karger AG, Basel.