|Prescribe an ACEi or ARB unless contraindicated.||Prescribe an ACEi or ARB if ACR > 30 mg/mmol and no contraindications.|
|Prescribe statin unless contraindicated.||
Age > 50: Prescribe statin unless contraindicated.
Age 18 – 49 : Prescribe statin if no contraindications and if any one of the following:
|Statin||eGFR < 60 mL/min/1.73m2|
|Simvastatin/Ezetmibe||20 mg/10 mg|
Recommended doses (mg/d) of statins in adults with CKD
Low dose ASA (81mg) may be used for secondary prevention in patients with established vascular disease:
If a patient with CKD is unable to maintain adequate fluid intake during an illness, it is recommended that potentially nephrotoxic or renally excreted drugs should be held until patient has recovered. As outlined in the CDA guidelines, this can be remembered using the acronym SADMAN (Sulfonylureas, ACEi, Diuretics, Metformin, ARB, NSAIDs).
These recommendations do not apply to patients with gestational diabetes.