Takaisin Tulosta

Statins for people with chronic kidney disease not requiring dialysis

Evidence summaries
8.12.2023 • Latest change 8.12.2023
Editors

Level of evidence: A

Statins reduce all-cause and cardiovascular mortality in chronic kidney disease patients compared with controls. Especially high-intensity statin therapy may modestly reduce proteinuria and rate of eGFR decline.

A Cochrane review «HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis»1 «Tunnicliffe DJ, Palmer SC, Cashmore BA, ym. HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis. Cochrane Database Syst Rev 2023;11(11):CD007784 »1 included 63 studies with a total of 50 725 subjects. In people with chronic kidney disease not requiring dialysis, statins consistently decreased major cardiovascular events (RR 0.72, 95% CI 0.66 to 0.79; 14 studies, n=36 156), all-cause mortality (RR 0.83, 95% CI 0.73 to 0.96; 13 studies, n=34 978) and cardiovascular deaths (RR 0.77, 95% CI 0.69 to 0.87; 8 studies, n=19 112), and MI (RR 0.55, 95% CI 0.42 to 0.73; 10 studies, n=9 475). There were no significant effects on stroke (RR 0.64, 95% CI 0.37 to 1.08; 7 studies, n=9 115), or kidney failure (RR 0.98, 95% CI 0.91 to 1.05, 3 studies, n= 6 704).

A meta-analysis «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. »2 included 57 RCTs with a total of 143 888 participants. Statin treatment did not produce an apparent beneficial effect for kidney failure events (OR 0.98; 95% CI, 0.87 to 1.10; P=0.7) or end-stage renal disease events (OR 0.98; 95% CI, 0.90 to 1.07; P=0.7). However, mean difference for rate of decline in eGFR (0.41, 95% CI 0.11 to 0.70) per year and standardized mean difference for change in proteinuria or albuminuria (-0.65, 95% CI -0.94 to -0.37 standard deviation units) in statin recipients were statistically significant compared to controls. Statin therapy significantly reduced the risk for cardiovascular events (OR 0.69; 95% CI, 0.61 to 0.79; P<0.001).

References

  1. Tunnicliffe DJ, Palmer SC, Cashmore BA, ym. HMG CoA reductase inhibitors (statins) for people with chronic kidney disease not requiring dialysis. Cochrane Database Syst Rev 2023;11(11):CD007784 «PMID: 38018702»PubMed
  2. 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