American Board of Internal Medicine (ABIM) Certification Practice Exam

Which of the following is a risk factor for statin-associated adverse effects?

1. Age under 50 years

2. Chronic kidney disease

3. High physical activity

4. Use of probiotics

The correct answer is: Chronic kidney disease

Chronic kidney disease is indeed a significant risk factor for statin-associated adverse effects. Patients with impaired kidney function often experience a higher concentration of statins in their system due to decreased clearance. This can lead to an increased risk of side effects, particularly muscle-related issues like myopathy or rhabdomyolysis, which are well-documented concerns when using statins. Moreover, kidney function is pivotal in metabolizing and excreting medications, and when it is compromised, the potential for drug accumulation rises, heightening the risk of adverse outcomes related to statin therapy. Other factors, such as concurrent medications that may affect renal function or muscle metabolism, can further compound the risks in these patients. Thus, the presence of chronic kidney disease necessitates careful consideration and often closer monitoring when initiating or maintaining statin therapy. In contrast, factors such as being under 50 years old, high physical activity levels, or using probiotics do not demonstrate the same level of association with an increased risk of serious adverse effects from statins. Young adults generally have lower risks of experiencing adverse effects, while high physical activity often contributes positively to overall cardiovascular health and can help mitigate some risks associated with statin use. Similarly, probiotics have no established link to