High Cholesterol and Kidney Disease

Medically Reviewed by Jennifer Robinson, MD on July 14, 2023
3 min read

Cholesterol is a waxy substance. Your body makes it and uses it to build your cells. You also get it from many foods. But having too much cholesterol can lead to health problems.

High cholesterol can build up in arteries to increase your risk of a heart attack or stroke. It turns out that high cholesterol isn’t good for your kidneys either.

Some of the first clues linking high cholesterol to kidney disease came from a study called the Physicians’ Health Study. In it, researchers followed about 4,500 healthy men and collected samples of their blood over more than 10 years.

The researchers looked at how well the men’s kidneys were working using a creatinine test. This test shows how well your kidneys get waste out of your blood. They also looked at cholesterol levels.

When they looked at kidney function and cholesterol together, the researchers found that high total cholesterol and high low-density lipoprotein (LDL), or “bad” cholesterol, showed up more often in men whose kidneys weren’t working as well.

Men whose kidneys weren’t working as well also had lower levels of high-density lipoprotein (HDL), or “good” cholesterol. HDL cholesterol is good because it helps to keep cholesterol from building up inside blood vessels.

Another study of more than 15,000 men and women over 3 years also connected kidney disease to high blood lipids. Lower levels of “good” HDL cholesterol came with more risk for kidney disease. But this study found a stronger link between kidney problems and high triglycerides, which is another type of fat in the blood.

The findings suggested that high levels of LDL “bad” cholesterol or low levels of HDL “good" cholesterol in combination with high levels of other unhealthy blood lipids make kidney problems more likely. People with high cholesterol were about twice as likely to get chronic kidney disease over time.

People with kidney disease have more risk for heart problems. When your kidneys aren’t working well, it also changes the way your body handles cholesterol and other lipids. So, kidney disease and high cholesterol often go together.

Drugs that lower cholesterol can help to reduce the risk for heart attack and stroke. But are they OK to take if you have kidney disease?

Studies show that it’s often a good idea to take medicines to lower your cholesterol if you have early kidney disease. Most often, doctors prescribe drugs called statins for this. Studies suggest the treatment lowers cholesterol and helps to reduce the risk of heart problems or stroke.

It’s less clear if they help once kidney disease is further along. Statins may not be recommended either if you need dialysis or have had a kidney transplant. It’s also less clear whether treatment to lower cholesterol can help to keep your kidney disease from getting worse.

Another way to lower cholesterol with kidney disease is by eating right and taking other healthy lifestyle steps. For example, one study showed that a high-fiber diet lowered cholesterol in people with kidney disease.

To reduce unhealthy fat in your diet, you can:

  • Limit red and processed meat.
  • Choose skim, low-fat, or fat-free dairy instead of whole-milk products.
  • Avoid fried foods.
  • Cook with healthy oils such as vegetable oil.
  • Eat plenty of fruits, vegetables, whole grains, poultry, fish, and nuts.
  • Skip sodium-filled or sugar-sweetened foods and drinks.

Other lifestyle factors that may help include:

If you have high cholesterol and kidney disease or think you are at risk, talk to your doctor about steps you can take to help lower those risks.