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Nephrol Dial Transplant (2000) 15: 1118-1119
© 2000 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Should we reduce blood cholesterol to prevent cardiovascular disease among patients with chronic renal failure?

Colin Baigent1, and David C. Wheeler2

1 Clinical Trial Service Unit and Epidemiological Studies Unit, Harkness Building, Radcliffe Infirmary, Oxford, UK 2 Department of Nephrology, University Hospital NHS Trust, Edgbaston, Birmingham, UK

Introduction

There is general agreement that, among individuals without overt renal impairment, blood cholesterol is an important cause of coronary artery disease (CAD). Prospective observational studies among such individuals have shown that the relationship between CAD risk (plotted on a doubling scale) and blood total cholesterol is roughly linear, and that within the range studied there is no threshold below which a lower cholesterol level is not associated with a lower risk of CAD. Associations between CAD risk and blood cholesterol appear to be similarly ‘log-linear’ in high-risk populations, including those with established cardiovascular disease [1]. Large-scale randomized trials are required to assess how quickly an excess risk of CAD is reversed by treatments . . . [Full Text of this Article]

(a)Absolute risk of CAD in CRF

(b)Expected proportional effects of lowering cholesterol in CRF

Notes

References


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