K One year before and after the publication of this guideline, assess the proportion of adult kidney trans- plant recipients that receive treatment with a statin. K One year before and after the publication of this guideline, assess the prevalence of statin use among non-dialysis-dependent adults aged 18 49 years with CKD and at least one of the following risk factors: known coronary disease (MI or coronary revascularization), diabetes mellitus, previous ischemic stroke, or predicted 10-year risk of CHD death/non-fatal MI 410%. KEY POINTS K Coronary risk is sufficiently high to justify prescription of statins in people aged Z50 with non-dialysis-dependent CKD or a kidney transplant. K Coronary risk in people aged o50 years with non-dialysis- dependent CKD is lower, but the presence of additional cardiovascular risk factors may increase risk to justify statin prescription. Given the evidence that treatment with statins improve vascular outcomes in this population, such treatment is suggested for patients aged o50 years with non-dialysis-dependent CKD and known vascular disease (prior MI, coronary revascularization or stroke), diabetes, or other risk factors that increase the 10-year risk of coronary death or non-fatal MI (as estimated using a validated risk calculator) to 410%. K Patients with dialysis-dependent CKD should not be initiated on statin or statin/ezetimibe treatment, given the lack of evidence that such treatment is beneficial. However, statin or statin/ezetimibe treatment should not necessarily be discontinued among existing users when dialysis treatment is initiated. K Physicians should be alert to the possibility of toxicity resulting from substances that increase blood levels of statins (e.g., grapefruit juice, certain medications). 