Chronic kidney disease (CKD) occurs when your kidneys are damaged and over time lose the ability to work properly. Eventually, this can lead to kidney failure, where your kidneys don’t work well enough to remove waste products from your body.

When your kidneys aren’t working, they can’t remove waste and extra fluid from your blood. This puts you at risk for other complications, like anemia, weak bones, and malnutrition. About 26 million Americans have CKD, and millions more are at risk.

Heart disease is a major cause of death for people with kidney disease, which is why medications to control cholesterol and blood pressure are usually prescribed. Statins are often recommended as part of this treatment, but these cholesterol-lowering drugs are also said to possibly worsen kidney failure. So, are these medications really safe for people with CKD?

People who suffer from kidney failure who do not receive a kidney transplant receive dialysis treatment, which is a medical process where waste is artificially removed from the blood. Medications are also prescribed to treat other conditions associated with kidney failure. These include drugs that:

  • lower blood pressure
  • control blood sugar
  • lower cholesterol
  • treat anemia
  • relieve swelling from retaining fluids

People also often take supplements to protect their bones, like calcium and vitamin D.

Statins are one of the most commonly prescribed drugs for treating high cholesterol in the United States. Studies show that they’re also effective at preventing heart disease.

When high levels of low-density lipoprotein (LDL) or “bad cholesterol” are present, they can begin to build up in your blood vessels, causing a blockage. Statins work by blocking an enzyme in your liver that controls cholesterol production. Some are even able to help decrease the amount that has already started to form in blood vessels.

Statins come in pill form and are only available by prescription. Your doctor will typically prescribe a statin if your LDL cholesterol levels are above 100 mg/dL and you have other risk factors for heart disease or are in a high-risk group.

Seven types of statins are available in the United States:

  • simvastatin (Zocor)
  • pitavastatin (Livalo)
  • fluvastatin (Lescol)
  • lovastatin (Altoprev)
  • pravastatin (Pravachol)
  • rosuvastatin (Crestor)
  • atorvastatin (Lipitor)

Although there’s little dispute that statins are effective at lowering your cholesterol, there is some scientific debate over whether or not they’re safe for people with different stages of kidney disease.

One study found that statins can prevent heart attacks in people with early stages of CKD, but had little to no effect on people on dialysis. Another study showed that high-dose statins were 34 percent more likely to cause kidney damage in the first 120 days of treatment, but it’s also possible that statins at lower doses may not cause such side effects.

More research is still needed, particularly studies that focus on people with kidney disease.

Doctors carefully weigh the benefits of statin therapy against the risks for people with kidney failure. For example, if you have been diagnosed with both kidney failure and heart disease, you’re more likely to be prescribed a statin than someone with kidney failure who doesn’t show signs of heart disease.

Kidney damage is one of several reported risks and side effects for statins. Others include pain or weakness in the muscles, confusion, loss of memory, flushing, and rashes. You may also suffer liver damage, muscle damage, blood sugar spikes (which could increase your risk for type 2 diabetes), or digestive problems like diarrhea, gas, nausea, and constipation.

If you have kidney failure and heart disease, it’s possible that the benefits of treatment with statin therapy will outweigh the risks. Talk to your doctor about your individual treatment plan, which depends on what stage of kidney failure you’re in. You can decide together if a statin is right for your situation, and if so, what type and dose.