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Brand names: Atorvastatin, Rosuvastatin, Simvastatin • Drug class: HMG-CoA reductase inhibitors (cholesterol)
Statins lower LDL cholesterol and cardiovascular risk — the #1 killer in CKD patients. They're safe in kidney disease, though doses of some statins (simvastatin, rosuvastatin) are capped at low eGFR. Statins do NOT slow CKD progression, but the heart protection is essential.
CKD patients die of heart disease more than kidney failure — statins are a cornerstone of that prevention (SHARP trial: LDL reduction cut major vascular events in CKD/dialysis patients). Some statins are renally cleared and capped at low GFR (simvastatin 20 mg max below CrCl 30; rosuvastatin 5-10 mg max in CKD), while atorvastatin needs no renal adjustment.
SHARP trial: simvastatin+ezetimibe reduced major vascular events by 17% in CKD and dialysis patients
SHARP (Baigent C et al., Lancet 2011), 2011
Statins do not slow eGFR decline — benefit is cardiovascular
CKD lipid literature, 2020
Atorvastatin: no renal adjustment (preferred in advanced CKD). Rosuvastatin: 5 mg max starting dose, 10 mg max in CrCl <30. Simvastatin: max 20 mg if CrCl <30. All: monitor for muscle symptoms; check CK if myalgia.
Check your kidney functionThis page is educational. Medication decisions — especially dosing changes — must be made by your prescribing clinician.
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