Table 16.
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-C 100–129 mg/dl after only 3 months of TLC | Drug therapy considered optional for LDL-C 100–129 mg/dl |
Initial drug therapy for elevated LDL-C should be with a statin | Initial drug therapy for elevated LDL-C should be with a statin, bile acid sequestrant, or nicotinic acid |
Fibrates may be used in Stage 5 CKD 1) for patients with TG ≥ 500; and 2) for patients with TG ≥ 200 mg/dl with non-HDL-C ≥130 mg/dl who do not tolerate statins | Fibrates are contraindicated in CKD |
Gemfibrozil may be the fibrate of choice for treatment of high TG 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-C, high-density lipoprotein; TLC, therapeutic lifestyle changes.