In the judgment of the Work Group, these data warrant a strong recommendation. 2.1.2: In adults aged Z50 years with CKD and eGFR (GFR categories G1-G2) we recommend treatment with a statin. (1B) RATIONALE The risk of future coronary events in patients aged Z50 years with CKD is markedly increased, as compared to those without CKD, and the rate of coronary death or non-fatal MI in this population exceeds 10 per 1000 patient-years even in the absence of prior MI or diabetes (Table 3). Most patients have proteinuria and slightly reduced or normal eGFR; many such patients would have been included but not recognized in randomized trials of statins done in the general population, since many such trials did not assess proteinuria at baseline. On the other hand, this population was explicitly excluded from participa- tion in SHARP, for which the primary inclusion criterion was elevated serum creatinine [SCr] (hence, reduced eGFR). Existing data suggest that the relative benefit of statin treatment is not influenced by the presence of albuminuria: and the Cholesterol and Recurrent Events (CARE) both tested for an interaction between the presence of albuminuria and the effect of statin treatment on cardio- vascular events. Both found no significant interaction (p 0.7 and p 0.59, respectively), suggesting that the benefit of statins is similar in people with and without albuminuria. A randomized trial of pravastatin 40 mg daily vs. placebo in CKD patients with preserved GFR (i.e., eGFR categories G1-G2) but microalbuminuria found no significant risk reduction associated with pravastatin treatment on the risk of although the number of events was small (n 47). 