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Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes
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| Zeitschriftentitel: | Clinical Kidney Journal |
|---|---|
| Personen und Körperschaften: | , , , , , , , , |
| In: | Clinical Kidney Journal, 12, 2019, 4, S. 530-537 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Oxford University Press (OUP)
|
| Schlagwörter: |
| author_facet |
Markossian, Talar W Kramer, Holly J Burge, Nicholas J Pacold, Ivan V Leehey, David J Huo, Zhiping Schneider, Julia Ling, Benjamin Stroupe, Kevin T Markossian, Talar W Kramer, Holly J Burge, Nicholas J Pacold, Ivan V Leehey, David J Huo, Zhiping Schneider, Julia Ling, Benjamin Stroupe, Kevin T |
|---|---|
| author |
Markossian, Talar W Kramer, Holly J Burge, Nicholas J Pacold, Ivan V Leehey, David J Huo, Zhiping Schneider, Julia Ling, Benjamin Stroupe, Kevin T |
| spellingShingle |
Markossian, Talar W Kramer, Holly J Burge, Nicholas J Pacold, Ivan V Leehey, David J Huo, Zhiping Schneider, Julia Ling, Benjamin Stroupe, Kevin T Clinical Kidney Journal Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes Transplantation Nephrology |
| author_sort |
markossian, talar w |
| spelling |
Markossian, Talar W Kramer, Holly J Burge, Nicholas J Pacold, Ivan V Leehey, David J Huo, Zhiping Schneider, Julia Ling, Benjamin Stroupe, Kevin T 2048-8505 2048-8513 Oxford University Press (OUP) Transplantation Nephrology http://dx.doi.org/10.1093/ckj/sfy131 <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Both reduced glomerular filtration rate and increased urine albumin excretion, markers of chronic kidney disease (CKD), are associated with increased risk of atherosclerotic cardiovascular disease (ASCVD). However, CKD is not recognized as an ASCVD risk equivalent by most lipid guidelines. Statin medications, especially when combined with ezetimibe, significantly reduce ASCVD risk in patients with nondialysis-dependent CKD. Unless physicians recognize the heightened ASCVD risk in this population, statins may not be prescribed in the absence of clinical cardiovascular disease or diabetes, a recognized ASCVD risk equivalent. We examined statin use in adults with nondialysis-dependent CKD and examined whether the use differed in the presence of clinical ASCVD and diabetes.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>This study ascertained statin use from pharmacy dispensing records during fiscal years 2012 and 2013 from the US Department of Veterans Affairs Healthcare System. The study included 581 344 veterans aged ≥50 years with nondialysis-dependent CKD Stages 3–5 with no history of kidney transplantation or dialysis. The 10-year predicted ASCVD risk was calculated with the pooled risk equation.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Of veterans with CKD, 62.1% used statins in 2012 and 55.4% used statins continuously over 2 years (2012–13). Statin use in 2012 was 76.2 and 75.5% among veterans with CKD and ASCVD or diabetes, respectively, but in the absence of ASCVD, diabetes or a diagnosis of hyperlipidemia, statin use was 21.8% (P &lt; 0.001). The 10-year predicted ASCVD risk was ≥7.5% in 95.1% of veterans with CKD, regardless of diabetes status.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Statin use is low in veterans with nondialysis-dependent CKD in the absence of ASCVD or diabetes despite high-predicted ASCVD risk. Future studies should examine other populations.</jats:p> </jats:sec> Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes Clinical Kidney Journal |
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Oxford University Press (OUP), 2019 |
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Oxford University Press (OUP), 2019 |
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2048-8505 2048-8513 |
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| title |
Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_unstemmed |
Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_full |
Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_fullStr |
Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_full_unstemmed |
Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_short |
Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_sort |
low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| topic |
Transplantation Nephrology |
| url |
http://dx.doi.org/10.1093/ckj/sfy131 |
| publishDate |
2019 |
| physical |
530-537 |
| description |
<jats:title>Abstract</jats:title>
<jats:sec>
<jats:title>Background</jats:title>
<jats:p>Both reduced glomerular filtration rate and increased urine albumin excretion, markers of chronic kidney disease (CKD), are associated with increased risk of atherosclerotic cardiovascular disease (ASCVD). However, CKD is not recognized as an ASCVD risk equivalent by most lipid guidelines. Statin medications, especially when combined with ezetimibe, significantly reduce ASCVD risk in patients with nondialysis-dependent CKD. Unless physicians recognize the heightened ASCVD risk in this population, statins may not be prescribed in the absence of clinical cardiovascular disease or diabetes, a recognized ASCVD risk equivalent. We examined statin use in adults with nondialysis-dependent CKD and examined whether the use differed in the presence of clinical ASCVD and diabetes.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Methods</jats:title>
<jats:p>This study ascertained statin use from pharmacy dispensing records during fiscal years 2012 and 2013 from the US Department of Veterans Affairs Healthcare System. The study included 581 344 veterans aged ≥50 years with nondialysis-dependent CKD Stages 3–5 with no history of kidney transplantation or dialysis. The 10-year predicted ASCVD risk was calculated with the pooled risk equation.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Results</jats:title>
<jats:p>Of veterans with CKD, 62.1% used statins in 2012 and 55.4% used statins continuously over 2 years (2012–13). Statin use in 2012 was 76.2 and 75.5% among veterans with CKD and ASCVD or diabetes, respectively, but in the absence of ASCVD, diabetes or a diagnosis of hyperlipidemia, statin use was 21.8% (P &lt; 0.001). The 10-year predicted ASCVD risk was ≥7.5% in 95.1% of veterans with CKD, regardless of diabetes status.</jats:p>
</jats:sec>
<jats:sec>
<jats:title>Conclusions</jats:title>
<jats:p>Statin use is low in veterans with nondialysis-dependent CKD in the absence of ASCVD or diabetes despite high-predicted ASCVD risk. Future studies should examine other populations.</jats:p>
</jats:sec> |
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| author | Markossian, Talar W, Kramer, Holly J, Burge, Nicholas J, Pacold, Ivan V, Leehey, David J, Huo, Zhiping, Schneider, Julia, Ling, Benjamin, Stroupe, Kevin T |
| author_facet | Markossian, Talar W, Kramer, Holly J, Burge, Nicholas J, Pacold, Ivan V, Leehey, David J, Huo, Zhiping, Schneider, Julia, Ling, Benjamin, Stroupe, Kevin T, Markossian, Talar W, Kramer, Holly J, Burge, Nicholas J, Pacold, Ivan V, Leehey, David J, Huo, Zhiping, Schneider, Julia, Ling, Benjamin, Stroupe, Kevin T |
| author_sort | markossian, talar w |
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| container_title | Clinical Kidney Journal |
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| description | <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Both reduced glomerular filtration rate and increased urine albumin excretion, markers of chronic kidney disease (CKD), are associated with increased risk of atherosclerotic cardiovascular disease (ASCVD). However, CKD is not recognized as an ASCVD risk equivalent by most lipid guidelines. Statin medications, especially when combined with ezetimibe, significantly reduce ASCVD risk in patients with nondialysis-dependent CKD. Unless physicians recognize the heightened ASCVD risk in this population, statins may not be prescribed in the absence of clinical cardiovascular disease or diabetes, a recognized ASCVD risk equivalent. We examined statin use in adults with nondialysis-dependent CKD and examined whether the use differed in the presence of clinical ASCVD and diabetes.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>This study ascertained statin use from pharmacy dispensing records during fiscal years 2012 and 2013 from the US Department of Veterans Affairs Healthcare System. The study included 581 344 veterans aged ≥50 years with nondialysis-dependent CKD Stages 3–5 with no history of kidney transplantation or dialysis. The 10-year predicted ASCVD risk was calculated with the pooled risk equation.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Of veterans with CKD, 62.1% used statins in 2012 and 55.4% used statins continuously over 2 years (2012–13). Statin use in 2012 was 76.2 and 75.5% among veterans with CKD and ASCVD or diabetes, respectively, but in the absence of ASCVD, diabetes or a diagnosis of hyperlipidemia, statin use was 21.8% (P &lt; 0.001). The 10-year predicted ASCVD risk was ≥7.5% in 95.1% of veterans with CKD, regardless of diabetes status.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Statin use is low in veterans with nondialysis-dependent CKD in the absence of ASCVD or diabetes despite high-predicted ASCVD risk. Future studies should examine other populations.</jats:p> </jats:sec> |
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| imprint | Oxford University Press (OUP), 2019 |
| imprint_str_mv | Oxford University Press (OUP), 2019 |
| institution | DE-Brt1, DE-Zwi2, DE-D161, DE-Gla1, DE-Zi4, DE-15, DE-Pl11, DE-Rs1, DE-105, DE-14, DE-Ch1, DE-L229, DE-D275, DE-Bn3 |
| issn | 2048-8505, 2048-8513 |
| issn_str_mv | 2048-8505, 2048-8513 |
| language | English |
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| physical | 530-537 |
| publishDate | 2019 |
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| publisher | Oxford University Press (OUP) |
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| spelling | Markossian, Talar W Kramer, Holly J Burge, Nicholas J Pacold, Ivan V Leehey, David J Huo, Zhiping Schneider, Julia Ling, Benjamin Stroupe, Kevin T 2048-8505 2048-8513 Oxford University Press (OUP) Transplantation Nephrology http://dx.doi.org/10.1093/ckj/sfy131 <jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Both reduced glomerular filtration rate and increased urine albumin excretion, markers of chronic kidney disease (CKD), are associated with increased risk of atherosclerotic cardiovascular disease (ASCVD). However, CKD is not recognized as an ASCVD risk equivalent by most lipid guidelines. Statin medications, especially when combined with ezetimibe, significantly reduce ASCVD risk in patients with nondialysis-dependent CKD. Unless physicians recognize the heightened ASCVD risk in this population, statins may not be prescribed in the absence of clinical cardiovascular disease or diabetes, a recognized ASCVD risk equivalent. We examined statin use in adults with nondialysis-dependent CKD and examined whether the use differed in the presence of clinical ASCVD and diabetes.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>This study ascertained statin use from pharmacy dispensing records during fiscal years 2012 and 2013 from the US Department of Veterans Affairs Healthcare System. The study included 581 344 veterans aged ≥50 years with nondialysis-dependent CKD Stages 3–5 with no history of kidney transplantation or dialysis. The 10-year predicted ASCVD risk was calculated with the pooled risk equation.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>Of veterans with CKD, 62.1% used statins in 2012 and 55.4% used statins continuously over 2 years (2012–13). Statin use in 2012 was 76.2 and 75.5% among veterans with CKD and ASCVD or diabetes, respectively, but in the absence of ASCVD, diabetes or a diagnosis of hyperlipidemia, statin use was 21.8% (P &lt; 0.001). The 10-year predicted ASCVD risk was ≥7.5% in 95.1% of veterans with CKD, regardless of diabetes status.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>Statin use is low in veterans with nondialysis-dependent CKD in the absence of ASCVD or diabetes despite high-predicted ASCVD risk. Future studies should examine other populations.</jats:p> </jats:sec> Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes Clinical Kidney Journal |
| spellingShingle | Markossian, Talar W, Kramer, Holly J, Burge, Nicholas J, Pacold, Ivan V, Leehey, David J, Huo, Zhiping, Schneider, Julia, Ling, Benjamin, Stroupe, Kevin T, Clinical Kidney Journal, Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes, Transplantation, Nephrology |
| title | Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_full | Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_fullStr | Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_full_unstemmed | Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_short | Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_sort | low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| title_unstemmed | Low statin use in nondialysis-dependent chronic kidney disease in the absence of clinical atherosclerotic cardiovascular disease or diabetes |
| topic | Transplantation, Nephrology |
| url | http://dx.doi.org/10.1093/ckj/sfy131 |