Vnitr Lek 2025, 71(8):535-541

Why might it be appropriate to replace rosuvastatin with atorvastatin in patients with chronic kidney disease?

Kryštof Rückl
Interní oddělení Mělnická zdravotní, a. s.
Klinika nefrologie 1. LF UK a VFN v Praze

Despite excellent mortality data, rosuvastatin does not appear to be a suitable hypolipidemic agent in patients with chronic kidney disease due to the risk of rhabdomyolysis and direct tubulotoxicity. As part of nephroprotection, it seems appropriate to replace rosuvastatin with atorvastatin in patients at risk because atorvastatin has a similar hypolipidemic action and it has been documented as nephroprotective agent. When using rosuvastatin, the need for dose reduction adjusted to glomerular filtration rate is often not respected, which is documented in a small review of cases of acute kidney injury in rhabdomyolysis recorded from a district hospital during a two and a half years follow-up. The etiology of rhabdomyolysis is multifactorial and often combines multiple triggers all at once. A clue to when to consider the diagnosis of rhabdomyolysis can be a serum elevation of creatine kinase, myoglobin and transaminases.

Keywords: acute kidney injury, cardiovascular prevention, lipid-lowering agents, nephroprotection, rhabdomyolysis.

Accepted: November 26, 2025; Published: December 15, 2025  Show citation

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Rückl K. Why might it be appropriate to replace rosuvastatin with atorvastatin in patients with chronic kidney disease? Vnitr Lek. 2025;71(8):535-541.
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