{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:49:40Z","timestamp":1782103780625,"version":"3.54.5"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T00:00:00Z","timestamp":1782086400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Advanced chronic kidney disease (CKD; stages G4\u2013G5 not on dialysis) is associated with very high cardiovascular risk, and lipid control is particularly challenging due to reduced statin efficacy and frequent intolerance. Inclisiran, a small interfering RNA (siRNA) that inhibits hepatic PCSK9 synthesis, has demonstrated sustained LDL-C reductions in clinical trials, though data in advanced CKD remain scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and methods<\/jats:title>\n                    <jats:p>An observational, retrospective case series was conducted at a tertiary care hospital, including 10 patients with stage G4\u2013G5 non-dialysis CKD and elevated LDL-C despite optimized therapy or with statin intolerance. Inclisiran was administered following the standard regimen (day 0, day 90, and every 6 months thereafter). Lipid profile, renal function, and albuminuria were assessed at baseline, 3\u20136 months, and 12 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Patients had a mean age of 75 \u00b1 5 years with high cardiovascular comorbidity. Baseline LDL-C was 131.6 \u00b1 22.1 mg\/dl, falling to 46.1 \u00b1 26.5 mg\/dl at 1 year (mean reduction 65.6%). All patients responded to treatment; 80% achieved LDL-C &amp;lt; 70 mg\/dl and 60% achieved &amp;lt; 55 mg\/dl. Renal function remained stable (eGFR 22.7 vs. 23.7 ml\/min\/1.73 m\n                      <jats:sup>2<\/jats:sup>\n                      ). A 27.4% reduction in median albuminuria was observed; however, all patients were receiving maximized nephroprotective therapy concurrently, and this finding should not be attributed to inclisiran. No adverse events or major cardiovascular events were recorded.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Inclisiran demonstrates a marked and sustained LDL-C reduction in patients with advanced CKD, with an excellent safety profile and preserved renal function, supporting its use in this high-risk population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1881641","type":"journal-article","created":{"date-parts":[[2026,6,22]],"date-time":"2026-06-22T04:34:35Z","timestamp":1782102875000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Inclisiran in advanced chronic kidney disease (stage G4\u2013G5 non-dialysis): sustained LDL-C reduction and favorable safety profile at 1-year follow-up in a real-world case 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