Abstract: Atherosclerotic cardiovascular disease (ASCVD) remains the leading cause of death among patients with chronic kidney disease (CKD), who face significantly higher rates of cardiovascular events compared to the general population. Despite this increased risk, CKD patients are still undertreated with lipid-lowering therapies (LLT) for both primary and secondary prevention. This systematic review highlights the ongoing underrepresentation of CKD patients in past and current randomized clinical trials (RCTs) evaluating LLT, pointing to evidence gaps in managing dyslipidemia for this high-risk group. Due to the limited inclusion of CKD populations in clinical studies, current treatment approaches often rely on extrapolated data from the general population, raising concerns about their relevance and effectiveness in this subgroup. The results underscore the importance of conducting dedicated trials focused on specific lipid management strategies to reduce cardiovascular risk in this vulnerable population better.
