Heart Health

Chronic kidney disease, age 40–75

Your situation (severe hypercholesterolemia short-circuits the risk score) CKD stage 3–4, age 40–75

Recommendationckd-statinNo one has reached this rule yet

Moderate-intensity statin (± ezetimibe) on the diagnosis alone; LDL-C <100

Clinical review

All reviewers

No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.

What someone who reaches this rule is told

Word for word, as generated for the example person below. Figures in the text are theirs.

  • Strongly recommended

    Your kidney function alone is a reason to be on lipid-lowering treatment — a moderate-intensity statin, or a statin plus ezetimibe. Target LDL-C below 100 mg/dL (and non-HDL-C below 130).

    Chronic kidney disease at your level (eGFR 58, stage 3) between ages 40 and 75 is an independent indication in the 2026 guideline, in the same way diabetes is — the risk calculator does not have to agree. Kidney disease raises cardiovascular risk out of proportion to what a lipid panel suggests, and people with it are consistently under-treated.

    Guideline consensusRecommended by the guideline writing committee, drawing on trials plus expert judgement where trials run out.· Class I· checked 2026-09-12

    2026 ACC/AHA/Multisociety Guideline on the Management of Dyslipidemia · Class I

An example person who reaches it

Heart failure with a weak pump” — an illustrative profile, not a real user.

67-year-old manBP 126/76LDL 105eGFR 58UACR 60 mg/gheart failure, EF 32%10-yr PREVENT-ASCVD 6.4%

Their path through cholesterol

  1. Known ASCVD (prior heart attack, stroke, or revascularization)?No
  2. Your situation (severe hypercholesterolemia short-circuits the risk score)CKD stage 3–4, age 40–75 ← this rule
  3. Coronary artery calcium (CAC) score? (further testing beyond basic labs)Not measured

Where it sits

Asked after: No known cardiovascular disease

Then asks: Coronary artery calcium (CAC) score? (further testing beyond basic labs)

Sources

Cited by the recommendations above.

Review this rule

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Runs in lib/engine/lipidPathway.ts as ckd-statin.