Statin Use in Patients with CKD (Nondialysis) in Ambulatory Care: A Quality Improvement Project at a Rural Community Hospital

Background: Chronic kidney disease (CKD) is a known risk factor for cardiovascular disease (CVD). Statins have been shown to reduce CVD risk in CKD (Non-Dialysis) with or without diabetes. Methods: This is a quality improvement project at North Mississippi Medical Center as a retrospective analysis of 304,575 observations in a total of 178,722 patients. Data were extracted from an office or wellness visit at any Epic clinic between 7/1/2021 and 7/1/2022. CKD diagnosis was made based on an estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m2 for > 3 months. The estimated GFR was calculated by the CKD-EPI creatinine equation (2021). The 10-year atherosclerotic cardiovascular (ASCVD) risk was calculated using Pooled Cohort Equations, the risk was categorized as <5%, 5-7.4%, and ≥7.5-10% in patients who met CKD criteria. Results: Out of the total observations of 119,557 representing 43,557 patients, 8538 patients (20%) met the CKD criteria by eGFR. Demographic characteristics are shown in table 1. For patients with CKD (Non-Dialysis) and diabetes with a 10-year ASCVD risk of ≥7.5-10%, the majority (~75%) were on statins versus 18% being not on statins (figure1). Differently, only 65 % of CKD patients without diabetes with a 10-year ASCVD risk of ≥7.5-10% were found to be taking statins versus 25% not on statins (figure2). Conclusion: Statin is an underused protective shield in patients with CKD (Non-Dialysis) in the ambulatory setting.