Introduction

Although there have been several sub-group and post-hoc analyses of patients with chronic kidney disease (CKD) enrolled in major lipid-lowering trials, there have been very few prospective trials carried out in this patient population.

There have been two significant trials using statin therapy in end-stage renal disease (ESRD) that have not produced positive results. In the AURORA study, when compared to placebo among patients undergoing maintenance hemodialysis, the use of rosuvastatin (10 mg daily) did not have a significant impact on the composite primary endpoint of CV death, nonfatal MI and nonfatal stroke. Similarly, there was no CV benefit of atorvastatin 20 mg compared to plcebo among 1255 diabetic patients undergoing hemodialysis in the 4D study.

Given the high risk of patients with CKD, there is a real need for further research to determine the optimal intervention. The Oxford University Group embarked on The Study of Heart and Renal Protection (SHARP) to assess the effects of cholesterol-lowering therapy with a combination of simvastatin and a cholesterol-absorbing inhibitor (ezetimibe) among 9000 patients with CKD (approximately 6000 pre-dialysis and approx. 3000 on dialysis).  

We are pleased to provide you with this timely resource centre which we hope is of relevance to your practice.  In addition to peer reviewed publications, downloadable slide kits and other pertinent tools, we have included a series of recorded presentations (English and French) by national experts summarizing previous trial results, providing an in depth review of the SHARP Trial as well as their personal opinions on how these results should impact Canadian practice.

Should you have any questions, please do not hesitate to contact the Canadian Heart Research Centre at 416-977-8010 or via email at cmeinfo@chrc.net.

Thank you for taking the time to review the Lipid Management in CKD Patients: Clinical Implications of the SHARP Trial web resource centre.