Article Dans Une Revue Nephrology Dialysis Transplantation Année : 2019

ACHIEVEMENT OF LOW-DENSITY LIPOPROTEIN CHOLESTEROL EUROPEAN SOCIETY OF CARDIOLOGY TARGETS IN CHRONIC KIDNEY DISEASE: A PROSPECTIVE COHORT STUDY

Résumé

INTRODUCTION: To describe the characteristics of patients with moderate or advanced chronic kidney disease (CKD) according to whether they were receiving lipid-lowering therapy (LLT), and whether they achieved low-density lipoprotein cholesterol (LDL-C) European Society of Cardiology (ESC) treatment targets for high and very high-risk patients. METHODS: CKD-REIN is a prospective cohort study conducted in 40 nephrology clinics in France. It enrolled 3033 patients with moderate (stage G3) or advanced (stage G4/G5) CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2) at inclusion (2013−2016), who had not been on chronic dialysis or undergone kidney transplantation. RESULTS: The study population comprised 2542 patients (mean age 67±13 years, 34% women) with LDL-C measurements at baseline, 63% of whom were on LLT; 24% were at high (CKD stage 3, no CVD or diabetes) and 74% at very high (CKD stage 3 with diabetes or CVD, or CKD stage 4/5) cardiovascular risk. Among high-risk patients, 45% of those on statin with/without ezetimibe achieved the LDL-C treatment target (<2.6 mmol/L). Among very high-risk patients, the percentage at goal (<1.8 mmol/L) was 38% for stage 3 CKD, and 29% for stage 4/5 CKD. There was a trend towards higher achievement of LDL-C targets with increasing LLT intensity (adjusted odds ratio for moderate vs low intensity, 1.20, 95% confidence interval 0.92−1.56; high intensity 1.46, 1.02−2.09; p-value for trend=0.036). Compared with patients who remained on the same LLT at 1 year, patients who stopped LLT were less likely to be adherent with medications, more likely to have reported cramps at baseline, and had a worse CKD stage. CONCLUSIONS: A high percentage of patients with stage G3−G5 CKD who are eligible for LLT are not treated and those on LLT rarely achieve the ESC targets.

Dates et versions

hal-03578812 , version 1 (17-02-2022)

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Ziad Massy, Jean Ferrieres, Eric Bruckert, Celine Lange, Sophie Liabeuf, et al.. ACHIEVEMENT OF LOW-DENSITY LIPOPROTEIN CHOLESTEROL EUROPEAN SOCIETY OF CARDIOLOGY TARGETS IN CHRONIC KIDNEY DISEASE: A PROSPECTIVE COHORT STUDY. Nephrology Dialysis Transplantation, 2019, 34 (supplement 1), pp.FP384. ⟨10.1093/ndt/gfz106.FP384⟩. ⟨hal-03578812⟩
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