In addition, there are now also RCTs of statins in patients with CKD. The Assessment of LEscol in Renal Transplantation was a double-blind RCT of fluvastatin in 2102 kidney transplant recipients with serum cholesterol 4.0–9.0 mmol/L at least 6 months after transplantation [16]. The primary endpoint, major adverse Y-27632 clinical trial cardiac events (MACE), was not significantly different (P = 0.139) between the two groups, but important secondary endpoints were better with fluvastatin. In addition, after longer follow-up, the differences in MACE were learn more statistically significant [17]. Interestingly,

Die Deutsche Diabetes Dialyse (4-D) Studie [18], and the Study to Evaluate the Use of Rosuvastatin in Subjects on Regular Hemodialysis: An Assessment of Survival and Cardiovascular Events (AURORA) [19], both failed to produce reductions in MACE. A number of explanations have been given for these surprising results, including the possibility that many MACE were not atherosclerotic. The Study of Heart and Renal Protection enrolled 9270 patients with CKD (3023 on dialysis and 6247 not on dialysis) with no known history of myocardial infarction or coronary revascularization [20]. The primary endpoint, MACE, was reduced by treatment with simvastatin ATM/ATR assay 20 mg combined with ezetimibe 10 mg. Interestingly, in a subgroup analysis, there was no difference in MACE among dialysis patients. Also notable was the fact

that pre-specified endpoints of CKD progression among those not on dialysis at enrollment were not significantly different between the two groups. In light of the several RCTs of statins in patients with CKD,

at least two meta-analyses have been conducted [21, 22]. Although the two meta-analyses differed in design and in which studies were included, their results were Dynein very similar. They concluded that statins reduce the risk of CVD and all-cause mortality in CKD Stage 3–5, that evidence for benefit in dialysis patients is lacking, and that evidence for benefit after transplant is sparse. There was some evidence that statins may slow the progression of CKD, but this evidence was not conclusive. Guidelines for treatment of dyslipidemia in CKD Since there is now a substantial body of evidence from intervention trials in CKD, the Kidney Disease Global Outcomes (KDIGO) group convened an evidence review team and guideline work group to develop a clinical practice guideline [23]. The work group has produced a guideline that suggests treating CKD patients (not on dialysis) who are at risk for cardiovascular disease with a statin. Patients on dialysis need not start a statin, but they may continue to receive a statin if they were taking a statin before dialysis initiation. Summary This conference demonstrated that studying the relationship between lipid abnormalities and outcomes in patients with CKD remains a fruitful area of study.