Ezetimibe as a Potential Treatment for Dyslipidemia associated with Chronic Renal Failure and Renal Transplant

Individuals with chronic renal disease (CKD) are prone to have accelerated process of atherosclerosis. Importantly, cardiovascular disease is the main cause of morbidity and mortality in kidney transplant recipients. Recent studies suggest a potential benefit of the lipid lowering medications in preventing cardiovascular events in the CKD and the transplant populations. In particular, statin was shown to be effective in reducing low density lipoprotein (LDL)-cholesterol. However, refractory dyslipidemia and difficulty in lowering LDL to target were reported with the CKD and the kidney transplant patients. The second United Kingdom Heart and Renal protection study (UKHARP- II) showed that the addition of ezetimibe to simvastatin was safe and effective in treating dyslipidemia in CKD. Furthermore, the combination of ezetimibe and statin was also effective and safe in treating dyslipidemia in kidney transplant recipients. The Study of Heart and Renal Protection (SHARP) trial will evaluate the effects of lowering LDL-C with ezetimibe 10 mg and simvastatin 20 mg daily versus placebo in 9,000 patients with chronic kidney disease. The current evidence suggests that the addition of ezetimibe to satin is effective and safe in treating dyslipidemia in the CKD and the kidney transplant patients. Future clinical trials are needed to determine whether ezetimibe will reduce cardiovascular risk in the CKD patients.