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Recommended doses (mg/day) of statins for treatment of adults with CKD

Recommended doses (mg/day) of statins for treatment of adults with CKD
Statin eGFR stages G1 to G2 eGFR stages G3a to G5, including patients on dialysis or with a kidney transplant
Lovastatin General population ND
Fluvastatin General population 80*
Atorvastatin General population 20
Rosuvastatin General population 10Δ
Simvastatin-ezetimibe General population 20 (simvastatin) and 10 (ezetimibe)
Pravastatin General population 40
Simvastatin General population 40
Pitavastatin General population 2
Doses shown may differ from recommendations in approved product information for use in patients with kidney function impairment and are based on regimens shown to be beneficial in randomized trials conducted in patients with CKD; refer to UpToDate content on CKD. Lower doses than those used in major trials of statins in CKD populations may be appropriate for patients of Asian ancestry. Note that rosuvastatin 40 mg daily is not recommended for use in CKD G1 to G2 nontransplant patients, as it may increase the risk of adverse kidney events. Cyclosporine inhibits the metabolism of certain statins, resulting in higher blood levels, and some combinations are contraindicated. To determine specific interactions, use the Lexi-Interact program included with UpToDate.
CKD: chronic kidney disease; eGFR: estimated glomerular filtration rate; ND: no data available or not used.
For definitions of eGFR stages G1 through G5, refer to separate topic review of definition and staging of CKD, table on revised CKD classification based on GFR.
* Data based on ALERT.
¶ Data based on 4D.
Δ Data based on AURORA.
Data based on SHARP.
Reprinted by permission from Macmillan Publishers Ltd: Kidney International Supplements. KDIGO. Chapter 2: Pharmacological cholesterol-lowering treatment in adults. Kidney Int Suppl 2013; 3:271. Copyright © 2013. www.nature.com/kisup.
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