NICE’s updated CKD quality standard, updated from the previous 2011 edition, newly recommends that all CKD patients should be offered statins to help prevent CVD events.
Atorvastatin 20mg is recommended as the ‘preferred initial high-intensity statin because it is both clinically and cost-effective’, although it advises GPs and others to up the dose if the patient does not respond to treatment.
The guidance contains two further recommendations, amended from the 2011 guidance, which state CKD and high-risk patients should receive periodic eGFRcreatinine and albumin:creatinine testing and that patients should have their BP maintained within the recommended range.
Around 2.6m people live with CKD in England, and 60,000 people die prematurely each year due to the disease.
Professor 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.’
GPC clinical and prescribing lead Dr Andrew Green said: ‘I welcome the revision of this document which concentrates on the key aspects of care that make a difference to renal patients.
'Whether renal patients take statins long-term will depend on many factors, including patient preferences, their life expectancy, and their co-morbidities, but it is certainly an intervention which should be considered.
‘What I find most interesting is recognition of the flexibility that we require to deliver personalised care to our patients. This understanding is always a feature of conversations with senior NICE members which sometimes doesn’t come across in their communications, and it is good to see.’