What therapy adjustment is recommended for a 64-year-old man with CKD experiencing hyperlipidemia, after being monitored for a known ASCVD?

In the context of managing a 64-year-old man with chronic kidney disease (CKD) experiencing hyperlipidemia who has a history of atherosclerotic cardiovascular disease (ASCVD), maintaining the current medication regimen is a prudent choice.

Patients with CKD are at an increased risk for cardiovascular events, making lipid management particularly important. Statins are often utilized in this population due to their benefits in decreasing cardiovascular risk, even at lower renal function levels. If the patient is already on a statin that is effectively managing their lipid levels and has been well tolerated, it is typically advised to continue the current regimen rather than making changes that could inadvertently increase the risk of adverse effects or exacerbate renal issues.

Monitoring is crucial in this case; if the patient's lipid levels remain uncontrolled or if they face new challenges in their health status, then adjustments would be warranted. However, unless new issues arise or the medication is not effective, keeping the current medication allows for stability in managing both the hyperlipidemia and the associated cardiovascular risk. This approach minimizes the risks associated with frequent adjustments, particularly in patients with CKD who may have fluctuating pharmacokinetics due to their renal function.