The SHARP trial included 9270 participants with CKD (mean eGFR of 27 ml/min/1.73 m2 ) to receive simvastatin 20 mg plus ezetimibe 10 mg daily or placebo, and followed them for 5 years.14 Thirty-three percent of participants (n 3023) were receiving dialysis at randomiza- tion and 23% (n 2094) had diabetes. Statin plus ezetimibe therapy led to a significant 17% reduction in the relative hazard of the primary outcome of major atherosclerotic Table 4 | Recommended doses (mg/d) of statins in adults with CKD Statin eGFR G1-G2 eGFR G3a-G5, including patients on dialysis or with a kidney transplant Lovastatin GP nd Fluvastatin GP 801 Atorvastatin GP 202 Rosuvastatin GP 103 Simvastatin/Ezetmibe GP 20/104 Pravastatin GP 40 Simvastatin GP 40 Pitavastatin GP 2 All statins may not be available in all countries. Lower doses than those used in major trials of statins in CKD populations may be appropriate in Asian countries. Note that rosuvastatin 40 mg daily is not recommended for use in CKD 1-2 non- transplant patients, as it may increase the risk of adverse renal events. Cyclosporin inhibits the metabolism of certain statins resulting in higher blood levels. Data based on 1 SHARP. Abbreviations: eGFR, estimated glomerular filtration rate; GP, general population; nd, not done or not studied. events (coronary death, MI, non-hemorrhagic stroke, or any revascularization) compared with placebo (HR 0.83; 95% CI 0.74 0.94), driven by significant reductions in non-hemor- rhagic stroke and coronary revascularization. Among the 6247 patients with CKD not treated by dialysis at randomiza- tion, treatment with simvastatin plus ezetimibe did not reduce the risk of progression to end-stage renal disease (ESRD) requiring RRT. The risk of serious adverse events was similar in participants assigned to treatment and to control. 