fa dyslipiemi kdigo
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KDIGO
CLINICAL PRACTICE GUIDELINE
FOR LIPID MANAGEMENT
IN CHRONIC KIDNEY DISEASE
M. FAKHRUDDIN FAKHRY
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INTRODUCTION
CKD is defined as abnormalities of
kidney structure or function !resent for
" # mont$s %it$ im!lications for $ealt$
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&$e !rimary rationale for
!$armacolo'ical c$olesterol(lo%erin'
treatment is to reduce morbidity and
mortality from at$erosclerosis
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Alt$ou'$ se)eral different medications
lo%er *D*(C only re'imens includin' a
statin +includin' statin,e-etimibe $a)e
been con)incin'ly s$o%n to reduce t$erisk of ad)erse cardio)ascular e)ents in
CKD !o!ulations.
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Assessment of li!id status in adults %it$
CKD
/$armacolo'ical c$olesterol(lo%erin'
treatment in adults
&ri'lyceride(lo%erin' treatment in adults
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In adults %it$ ne%ly identi0ed CKD
+includin' t$ose treated %it$ c$ronic
dialysis or kidney trans!lantation %e
recommend e)aluation %it$ a li!id!ro0le +total c$olesterol *D*
c$olesterol HD* c$olesterol
tri'lycerides
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1.23 In adults %it$ CKD +includin' t$ose
treated %it$ c$ronic dialysis or kidney
trans!lantation follo%(u! measurement
of li!id le)els is not re4uired for t$ema5ority of !atients
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/$armacolo'ical c$olesterol(lo%erin'
treatment in adults
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2.1.13 In adults a'ed " 67 years %it$
e8FR9 :7ml,min,1.;# m2 but not
treated %it$ c$ronic dialysis or kidney
trans!lantation +8FR cate'ories 8#a(86 %e recommend treatment %it$ a
statin or statin,e-etimibe combination
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2.1.23 In adults a'ed "67 years %it$
CKD and e8FR ":7ml,min,1.;#m2
+8FR cate'ories 81(82 %erecommend treatment %it$ a statin.
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2.23 In adults a'ed 1? years %it$ CKD but not
treated %it$ c$ronic dialysis or kidney
trans!lantation %e su''est statin treatment in
!eo!le %it$ one or more of t$e follo%in' 3
kno%n coronary disease +myocardial infarction or
coronary re)asculari-ation
diabetes mellitus
!rior isc$emic stroke
estimated 17(year incidence of coronary deat$ or
non(fatal myocardial infarction "17@
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2.#.13 In adults %it$ dialysis(de!endent
CKD %e su''est t$at statins or
statin,e-etimibe combination not be
initiated
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2.#.23 In !atients already recei)in'
statins or statin,e-etimibe combination
at t$e time of dialysis initiation %e
su''est t$at t$ese a'ents be continued.
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2.>3 In adult kidney trans!lant reci!ients
%e su''est treatment %it$ a statin. +2
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&ri'lyceride(lo%erin' treatment in adults
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6.13 In adults %it$ CKD +includin' t$ose
treated %it$ c$ronic dialysis or kidney
trans!lantation and
$y!ertri'lyceridemia %e su''est t$att$era!eutic lifestyle c$an'es be ad)ised.
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Rule out remediable causes of
secondary dysli!idemia.
Bstablis$ t$e indication of treatment
+YB or N and select a'ent and dose. &reat accordin' to a EE0re(and(for'et
strate'y3 do not measure *D*(C unless
t$e results %ould alter mana'ement.
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SUMMARY
ebab kematian terbanyak !ada !asien
/8K adala$ /K
Disli!idemi meru!akan faktor resiko
ter5adinya /K 8uideline terbaru !en'endalian
disli!idemia !ada /8K
merekomendasikan !en''unaan statin
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trate'i !en'obatan yan' di'unakan
adala$ Fire and For'et
/asien HD re'uler tidak dian5urkan
!emberian statin /asien trans!lantasi 'in5al
direkomendasikan !emberian statin
Hi!ertri'liserida ditera!i den'anmodifikasi 'aya $idu!
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