KHA-CARI commentary on the KDIGO clinical practice guideline for lipid management in chronic kidney disease

Due to the markedly accelerated risks of cardiovascular disease for people who have chronic kidney disease (CKD),1 lipid‐lowering treatment represents a potentially effective intervention to reduce cardiovascular events, including death from cardiovascular disease. However, existing randomized trials have been inconsistent about whether statin therapy is beneficial for all patients with CKD, particularly those who are treated with dialysis,2-4 while data for recipients of a kidney transplant and children with CKD are sparse. Given the extensive trial data that have become available over recent years and in particular, information from the Study of Heart and Renal Protection (SHARP) trial of simvastatin/ezetimibe which involved more than 9000 adults with advanced kidney disease,3 lipid management is a highly relevant guideline for development by the Kidney Disease Improving Global Outcomes (KDIGO) group.5 The KDIGO ‘Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease’ was published in November 2013 and makes 13 recommendations.6 In this commentary, we consider the recommendations made in the KDIGO guideline with particular reference to the New Zealand and Australian context. Overall, the KDIGO guideline recommendations are suitable for Australasian clinical practice.