Lipids Guideline

Guiding Principles

Advanced Chronic Kidney Disease (ACKD) is associated with abnormalities of lipid metabolism. ACKD patients are typically initiated on a HMG-CoA Reductase Inhibitor (statin) with the intention of lowering their risk of cardiovascular related mortality and morbidity. 

For patients receiving conservative kidney management, lipid levels do not need to be monitored.

GFR 15 - 5 | Slow Decline/Deteriorating | Last 0-5 years of life

Patients will not likely receive benefit from remaining on statins in the last few years of life; some research even suggests an improvement in quality of life from stopping statins. In line with a conservative care philosophy of decreasing therapeutic burden, it is recommended that care providers, in discussion with the patient, discontinue statins for CKM patients.

GFR 5 - 0 | Intensive/Near Death | Last 0-2 months of life

If not discontinued already, statins should now be stopped.