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CKD Cardiovascular Risk — RACP Adult Medicine MCQ

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ModerateNephrologyCKD Cardiovascular RiskRACP Adult Medicine

A 70-year-old woman with CKD stage G3b (eGFR 38 mL/min/1.73m²) has an LDL of 3.5 mmol/L. She has no history of cardiovascular disease. What is the most appropriate lipid-lowering strategy?

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Correct answer: E — Atorvastatin 20 mg plus ezetimibe 10 mg daily

KDIGO 2024 recommends statin or statin/ezetimibe combination for adults ≥50 with eGFR <60 mL/min/1.73m² regardless of LDL level (Grade 1A). A moderate-intensity statin plus ezetimibe is the preferred approach. In CKD, the strategy is fire-and-forget rather than treat-to-target. No dose escalation to high-intensity is needed.

Reference: KDIGO – 2024 – CKD Guidelines; KDIGO 2013 Lipid Guidelines