Healthcare professionals should offer statins to the millions of people who have chronic kidney disease (CKD) to help manage their increased risk of cardiovascular disease (CVD), the National Institute for Health and Care Excellence (NICE), England’s health technology assessment body, has urged.
The new NICE quality standard says healthcare professionals should discuss statin therapy with everyone who is diagnosed with CKD.
The standard recommends Atorvastatin 20mg as the preferred high-density statin to offer patients diagnosed with CKD because it is “both clinically and cost effective”.
Around 2.6 million people in England have CKD and approximately 60,000 people die prematurely each year because of the disease, and research has shown a clear link between reduced kidney function and CVD.
Statins are widely used as the go-to solution by healthcare professionals for the prevention of heart disease owing to their ability to slash LDL-C levels, a ‘surrogate marker’ of CVD.
The NICE guidance states that adults who have CKD or who are at risk of CKD should have their estimated glomerular filtration rate (eGFR) creatinine, and albumin:creatinine ratio tested at a frequency agreed with their healthcare professional. It also advised that healthcare professionals should support adults with CKD to keep their blood pressure within the recommended range.
Gillian Leng, deputy chief executive at NICE, said: “We know that a high number of people with long-term kidney problems will develop cardiovascular disease. This means they have an increased risk of suffering a fatal heart attack or stroke.
“It is important for healthcare professionals to speak to patients about their treatment options. The effectiveness of statins is now well proven, as is their long-term safety. They may appeal to a lot of people who are at risk.”
Helen Stokes-Lampard, chair of the Royal College of General Practitioners, said statins have been found to be “highly effective drugs at preventing cardiovascular disease by reducing the cholesterol levels of patients, and extensive research has shown that taking them is safe”.
However, she cautioned that “patients should only take medication if they need to, and specifically if they are at high risk of developing conditions that statins can help prevent”.
She added that “as with any drug, taking statin medication has potential side effects”, and that it was “important that as new evidence becomes available, it is taken onboard as guidelines for healthcare professionals are updated”.
Workload implications for healthcare professionals “with so many people being potentially eligible for statin therapy is enormous, so this must be matched with appropriate resources”, she cautioned.