Table 4.

Key Features of the K/DOQI Guidelines that Differ from NCEP ATP III

NKF K/DOQI Guidelines	ATP III Guidelines
CKD patients are considered to be in the highest risk category	CKD patients are not managed differently from other patients
Evaluation of dyslipidemias should occur at presentation, after a change in status, and annually	Evaluation of dyslipidemias should occur every 5 years
Drug therapy should be used for LDL 100 to 129 mg/dl after only 3 months of TLC	Drug therapy considered optional for LDL 100–129 mg/dl
Initial drug therapy for elevated LDL should be with a statin	Initial drug therapy for elevated LDL should be with a statin, bile acid sequestrant, or nicotinic acid
Fibrates may be used in Stage 5 CKD 1) for patients with triglycerides ≥500; and 2) for patients with triglycerides ≥200 mg/dl with non-HDL cholesterol ≥130 mg/dl who do not tolerate statins	Fibrates are contraindicated in CKD
Gemfibrozil may be the fibrate of choice for treatment of high triglycerides in patients with CKD	No preferences for which fibrate should be used for hypertriglyceridemia

CKD, chronic kidney disease; NKF K/DOQI, National Kidney Foundation Kidney Disease Outcomes Quality Initiative; NCEP ATP III, National Cholesterol Education Program Adult Treatment Panel III; LDL, low-density lipoprotein; HDL, high-density lipoprotein; TLC, therapeutic lifestyle changes.

Reproduced and modified with permission from the NKF K/DOQI guidelines on treating dyslipidemia.³