Given less concern about drug toxicity in the setting of better kidney function, (and no history of kidney transplantation) may be treated with any statin regimen that is approved for use in the general population. In the judgment of the Work Group, existing evidence does not support a specific on-treatment LDL-C target and thus adjusting the dose of statin regimens based on LDL-C levels is not required. Safety data from large clinical trials suggest that the excess risk of adverse events associated with these regimens is similar among people with and without CKD. In the judgment of the Work Group, these considerations suggest that measurement of creatine kinase (CK) or liver enzyme assays is not required in asymptomatic patients. Certain medications and grapefruit juice increase blood levels of statins (Supplemental Tables 19, 20 online). If such medications are required in patients who are otherwise good candidates for statin treatment, physicians may consider one of two strategies. For medications that will be required only for short periods (such as an antibiotic), the statin could be temporarily discontinued. For medications that will be required for more than a few days, a switch to an alternative statin or reducing the statin dose could be considered to reduce the risk of drug toxicity. Patients with CKD appear to be at increased risk of adverse events when statins and fibrates are used in combination (Supplemental Tables 21 28 online). For this reason, the Work Group recommends that fibrates not be used concomitantly with statins in patients with CKD. As mentioned earlier, given that evidence of clinical benefit is greater for statins than for fibrates, the Work Group recommends that statins be prescribed in preference to fibrates when clinicians are trying to choose between the two classes of medication. 