title: Effects of long-term treatment with simvastatin on some hemostatic parameters in continuous ambulatory peritoneal dialysis patients.
abstract: OBJECTIVE
  Disturbances in serum lipids, hemostasis and platelet functions are frequent features in uremia and may contribute to the progression of atherosclerosis and its thrombotic complications. Recently, attention has been paid to beneficial effects of statins on serum lipids and hemostasis in uremic patients. Peritoneally dialyzed (continuous ambulatory peritoneal dialysis; CAPD) subjects are particularly prone to dyslipidemia and have a high risk of cardiovascular death. The purpose of this work was to assess platelet functions, some hemostatic parameters and serum lipids in 8 hyperlipidemic CAPD patients treated with simvastatin (Zocor, MSD) for 6 months.
  
  
  METHODS
  Platelet aggregation in whole blood and in platelet-rich plasma (PRP) induced by collagen (2 microg/ml for whole blood and PRP), arachidonic acid (0.75 mM for whole blood and PRP), ADP (10 microM for whole blood and 5 microM for PRP) and ristocetin (0.75 mg/ml for whole blood and 1.5 mg/ml for PRP) was studied before and after 1, 3 and 6 months of simvastatin (dose: 10 mg at bedtime) treatment.
  
  
  RESULTS
  Whole-blood platelet aggregation induced by collagen decreased significantly after 3 and 6 months of the therapy, whereas in PRP, platelet aggregation induced by collagen and ADP decreased significantly after 6 months. Ristocetin-induced platelet aggregation in PRP decreased significantly after 3 and 6 months of simvastatin therapy. P-selectin remained unaltered by 6 months of simvastatin therapy. The fibrinolytic activity index was significantly higher after 3 months of the therapy when compared to the baseline values. Thrombomodulin, a marker of endothelial cell injury, was significantly lower after 3 and 6 months of the therapy. Prothrombin fragments 1 + 2 did not change significantly during 6 months of simvastatin administration. Cholesterol and LDL fell significantly as early as after 1 month and remained lowered during further months of the therapy.
  
  
  CONCLUSIONS
  Simvastatin is an effective hypolipemic agent and favorably affects platelet aggregation, endothelial function and fibrinolysis in CAPD patients.
authors.affiliation: Department of Nephrology and Internal Medicine, Medical School, PL-15-540 Białystok, Zurawia 14, Poland. jolmal@poczta.snet.pl
authors.forename: J
authors.initials: J
authors.lastname: Małyszko
authors.forename: J S
authors.initials: JS
authors.lastname: Małyszko
authors.forename: T
authors.initials: T
authors.lastname: Hryszko
authors.forename: M
authors.initials: M
authors.lastname: Myśliwiec
mesh_terms: D016718:Arachidonic Acid / Q000494:pharmacology; D002784:Cholesterol / Q000097:blood; D003094:Collagen / Q000494:pharmacology; D005260:Female; D005342:Fibrinolysis / Q000187:drug effects; D006487:Hemostasis; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory; D010974:Platelet Aggregation / Q000187:drug effects*; D012310:Ristocetin / Q000494:pharmacology; D019821:Simvastatin / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D018180:Thrombomodulin / Q000097:blood
chemical_list: D000960:Hypolipidemic Agents; D008077:Lipoproteins, LDL; D018180:Thrombomodulin; D012310:Ristocetin; D016718:Arachidonic Acid; D003094:Collagen; D002784:Cholesterol; D019821:Simvastatin