CKD Cardiovascular Risk — ESENeph MCQ
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Correct answer: D — Offer atorvastatin 20 mg for primary cardiovascular prevention in CKD
The best answer is “Offer atorvastatin 20 mg for primary cardiovascular prevention in CKD”. NICE recommends atorvastatin 20 mg for people with CKD for primary or secondary prevention, with interaction and adverse-effect review and dose escalation based on response and eGFR. “Defer statin treatment while reviewing interactions and previous intolerance” is less appropriate because CKD strengthens rather than removes the prevention indication “Use a fibrate when severe hypertriglyceridaemia provides a separate indication” is less appropriate because this is not the NICE CKD prevention strategy and renal dosing matters “Use a PCSK9 inhibitor after appropriate specialist lipid-treatment assessment” is less appropriate because initial treatment is atorvastatin unless contraindicated or not tolerated “Begin secondary-prevention treatment after a cardiovascular event has occurred” is less appropriate because primary prevention is recommended in CKD
Reference: NICE NG238: cardiovascular risk assessment and lipid modification: https://www.nice.org.uk/guidance/ng238/chapter/Recommendations