Discussion
There were four major findings in this
atherosclerotic cohort study. First, atherosclerotic
patients with CKD had more comorbidities and
received more evidence-based medicine than those
without CKD. Second, patients with and without
CKD received equal potency statin. Third, lipid goal
attainment was suboptimal and lower in CKD
subjects especially in HDL and TG. Fourth, female
subjects had higher percentage not to attain lipid
goals especially in TG and non-HDL-C.
CKD is an important poor predictor of prognosis
in those with atherosclerosis [11, 12]. More extensive
and severe atherosclerosis coronary tree with plaque
composed of greater necrotic core and less fibrous
tissue were found in the CKD than non-CKD subjects
[13]. Although there is no particular reason not to
treat CKD patients just like patients without renal
dysfunction, physicians prescribed fewer
guideline-recommended treatments even in the
absence of contraindications [14]. Furthermore, poor
awareness of CKD and its risk in patients with CAD is
a big challenge both for the physcians and patients
[15]. As shown in our study, those with CKD had
more comorbidities and received more
guideline-recommended medications. Because
education and prevention strategies are very
important both for physcians and CKD patients, our
nationwide CKD Preventive Project with
multidisciplinary care programmay play an
important role in prescribing the evidence-based
medicine by physcians in Taiwan [4].