CKD, HTN and hyperlipidaemia Flashcards
How do you prevent AKI?
- Monitor renal func in pt w CKD, HF, CLD and DM
- Monitor renal func in pt w acute illness, esp if D+V and dehydration
- Avoid nephrotoxic drugs in pt w CKD eg. NSAIDs, ACEi/ARBs, diuretics
- In all people w acute illness w hypovolaemia
When should you suspect familial hypercholesterolaemia?
- Total cholesterol >7.5mmol/L
- FH of premature CHD (event before 60yo)
- Tendon xathomas or corneal arcus
How do you treat a pt w familial hypercholesterolaemia?
These patients are at high risk of CVD and need high intensity lipid lowering treatment
What common conditions and drug cause hyperlipidaemia?
- Diuretics
- Corticosteroids
- Immunosuppressants
- Oral oestrogen
- B blockers
- Antidepressants
- T2DM
- Hypothyroidism
- Pregnancy
- Menopause
- Increasing age
What are the doses of high vs med intensity statins?
Atorvastatin 10 mg = med intensity
20/40/80 mg = high intensity
What blood tests should be done before commencing statins?
- Non fasting lipid profile
- LFTs
- Renal func inc eGFR
- HbA1c
- CK
- TSH
Who should be offered lipid modification? Based on QRISK score
- QRISK 10%+
- T2 diabetics 10%+ QRISK
- Consider in all people w T1DM but offer to those >40, have had >10 years or have CVD risk factors
- CKD pt
- Familial hypercholesterolaemia (ezetimibe)
What statin treatment is recommended for primary prevention?
Atorvastatin 20 mg and if statins contraindicated seek specialist advise
What statin treatment is recommended for secondary prevention?
High intensity statin treatment = atorvastatin 80mg
What is the follow up of a pt using lipid modification for primary prevention?
- 3 months after starting = total cholesterol, HGL and non HDL cholesterol measured
- Hope to have >40% reduction in non HDL C
- Recheck LFTs at 3 and 12 months
- Review statin annually and ask about SEs
