Statins for improving renal outcomes
Statins may have a small effect in slowing the rate of loss of kidney function, especially in patients with cardiovascular disease. However, statins reduce all-cause and cardiovascular mortality in patients with chronic kidney disease.
A systematic review «Sandhu S, Wiebe N, Fried LF, Tonelli M. Statins for improving renal outcomes: a meta-analysis. J Am Soc Nephrol 2006 Jul;17(7):2006-16. »1 including 27 studies with a total of 39 704 subjects was abstracted in DARE. Studies included patients with cardiovascular disease (CVD), glomerulonephritis, diabetes, hypertension, hyperlipidaemia and general patients. Studies of patients with end-stage renal disease were excluded. The included studies evaluated atorvastatin, pravastatin, fluvastatin, simvastatin, lovastatin and cerivastatin. Overall, the change in the weighted mean differences for eGFR was statistically significant (1.22 ml/min per yr slower in statin recipients; 95% CI 0.44 to 2.00). There was substantial heterogeneity (I-squared 96%). The effect of statins remained statistically significant with a smaller treatment effect when only higher quality studies were analysed. In subgroup analysis, the benefit of statin therapy was statistically significant in studies of participants with CVD (0.93 ml/min per yr slower than control subjects; 95% CI 0.10 to 1.76) but was non-significant for studies of participants with diabetic or hypertensive kidney disease or glomerulonephritis. There were no significant differences between statins and control in the rate of change in proteinuria (reduction in WMD 0.37 g/24 hours, 95% CI -0.75 to 0.02) or albuminuria (reduction in WMD -0.02 g/24 hours, 95% CI -0.06 to 0.02); substantial heterogeneity was found (I-squared 83% and 92%, respectively).
This document is linked to the following articles:
- Dyslipidemiat 1
- Sandhu S, Wiebe N, Fried LF, Tonelli M. Statins for improving renal outcomes: a meta-analysis. J Am Soc Nephrol 2006 Jul;17(7):2006-16. «PMID: 16762986»PubMed «DARE-12006002842»DARE
- Su X, Zhang L, Lv J et al. Effect of Statins on Kidney Disease Outcomes: A Systematic Review and Meta-analysis. Am J Kidney Dis 2016;67(6):881-92. «PMID: 26905361»PubMed
- Palmer SC, Navaneethan SD, Craig JC et al. HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis. Cochrane Database Syst Rev 2014;(5):CD007784. «PMID: 24880031»PubMed