The cost-effectiveness of lipid lowering for primary cardiovascular prevention in chronic kidney disease: moving beyond statins

We describe the importance of this topic and explain key assumptions necessary for the investigators to arrive at their conclusions.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Commentary Source Type: research

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By WILLIAM H. BESTERMANN JR., MD New Scientific Breakthroughs Can Provide a Longer Healthier Life Twenty-one years of follow-up comparing usual care with a protocol-driven team-based intervention in diabetes proved that healthy life in humans can be prolonged by 8 years. These results were achieved at a lower per patient per year cost. Aging researchers have been confident that we will soon be able to prolong healthy life. This landmark study shows this ambitious goal can be achieved now with lifestyle intervention and a few highly effective proven medications. These medications interfere with the core molecular biol...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Patients aging chronic disease Denmark Diabetes William Bestermann Source Type: blogs
AbstractPurpose of ReviewNon-dialysis-dependent chronic kidney disease (NDD-CKD) patients are at an increased risk of cardiovascular disease (CVD) –related deaths in comparison with the general population. This review summarizes recent guideline recommendations and studies on primary and secondary prevention of traditional cardiovascular (CV) risk factors in those with NDD-CKD.Recent FindingsThe use of antiplatelet agents for primary prevention in CKD is not supported by clinical trial evidence; however, they offer potential benefits when used for secondary prevention of CVD in the absence of an elevated bleeding ris...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research
AbstractCardiovascular disease (CVD) continues to be the leading cause of death in Western civilizations, and hyperlipidemia is a well-established independent risk factor for the development of atherosclerosis and CVD progression. Many chronic kidney disease (CKD) and dialysis patients have the traditional CVD risk factors (age, obesity, hypertension, diabetes mellitus, and hyperlipidemia); however, CKD and dialysis predispose patients to several non-traditional risk factors, including myocardial remodeling, hyperparathyroidism, malnutrition, bone and mineral disorders, anemia, albuminuria, inflammation, and endothelial dy...
Source: Drugs and Therapy Perspectives - Category: Drugs & Pharmacology Source Type: research
Statin-based treatments reduce cardiovascular disease (CVD) risk in patients with non-dialysis chronic kidney disease (CKD), but it is unclear which regimen is the most cost-effective. We used the Study of Heart and Renal Protection (SHARP)CKD-CVD policy model to evaluate the effect of statins and ezetimibe on quality-adjusted life years (QALYs) and healthcare costs in the United States (US) and the United Kingdom (UK). Net costs below $100,000/QALY (US) or £20,000/QALY (UK) were considered cost-effective.
Source: Kidney International - Category: Urology & Nephrology Authors: Tags: Clinical Investigation Source Type: research
ConclusionsHigher VLDL-C and Apo-B levels, as well as lower HDL-C and Apo-AI levels, are associated with increased risk for ASCVD. These findings support future investigations into pharmacologic targeting of lipoproteins beyond LDL-C, such as triglyceride-rich lipoproteins, to reduce residual risk for ASCVD among individuals with CKD.
Source: American Journal of Kidney Diseases - Category: Urology & Nephrology Source Type: research
Erythropoiesis-stimulating agents (ESAs) are frequently used among patients with renal anemia, while a significant proportion of patients exhibit ESA hyporesponsiveness despite adequate dosing. Previous studies have suggested an inverse association between ESA hyporesponsiveness and statin use among patients receiving dialysis therapy. However, studies based on predialysis patients are extremely limited. Based on electronic medical records of a tertiary hospital in Beijing, China between April 2010 and April 2015, we investigated the association between statin use and ESA hyporesponsiveness among patients with predialysis...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
orris Cardiovascular disease (CVD) burden is several-fold higher in patients with chronic kidney disease (CKD). Although statins have been shown to provide significant CVD benefits in both the general population and patients with CKD, this has not translated into survival advantage in patients with advanced CKD or on dialysis. It has been reported that CVD risk continues to escalate as CKD progresses to end-stage kidney disease (ESKD); however, the CVD risk reduction by statins appears to decline as patients’ progress from the early to later stages of CKD. Statins have also been associated with a higher incid...
Source: International Journal of Environmental Research and Public Health - Category: Environmental Health Authors: Tags: Review Source Type: research
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Source: Clinical Transplantation - Category: Transplant Surgery Authors: Tags: Review Article Source Type: research
Conclusions: Obesity did not confer an increased risk of ESRD in patients with moderate to advanced CKD. This trial was registered at http://www.clinicaltrials.gov as NCT03285074. PMID: 30321257 [PubMed - as supplied by publisher]
Source: The American Journal of Clinical Nutrition - Category: Nutrition Authors: Tags: Am J Clin Nutr Source Type: research
This study was a multi-center observational registry, the Taiwanese Secondary Prevention for patients with AtheRosCLErotic disease (T-SPARCLE) Registry. This study follows up patients with CV diseases in Taiwan who have secondary prevention therapies. The primary outcome is the time of first occurrence of a major adverse cardiac events (MACEs).Result5388 patients with ASCVD were included and 1478 (27.4%) had CKD without dialysis. CKD patients had higher TG and lower LDL-C levels. The incidence of recurrent MACEs per 1000 person-years in CKD patients was 19.5 (95% CI 15.5–24.9), compared with 9.1 (95% CI 7.4–11....
Source: Journal of the Formosan Medical Association - Category: General Medicine Source Type: research
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