Decreased erythropoietin requirements in maintenance hemodialysis patients with statin therapy.
Inflammatory cytokines induce erythropoietin (EPO) resistance, anorexia, and suppression of hepatic albumin synthesis. Increased levels of C-reactive protein (CRP) have been associated with relative EPO resistance in dialysis patients. More recently, studies have shown that statin therapy decreases CRP. This study analyzed the effect of statin therapy on EPO requirements in dialysis patients. This retrospective, single center study stratified stable hemodialysis patients into two groups: Group 1, statin therapy (n = 19), and Group 2, nonstatin therapy (n = 19). Group 1 was subclassified into Group 1a (prestatin therapy) and Group 1b (poststatin therapy). Baseline demographics, biochemical parameters [serum lipid panel, hemoglobin (Hgb), transferrin saturation (TSAT), ferritin, parathyroid hormone (PTH), aluminum, albumin, KT/V, urea reduction ratio (URR), and protein catabolic rate (nPCR)] and EPO requirements (u/kg per treatment) were obtained. Poststatin labs were obtained at a mean of 4.7 months. Statistically significant changes were noted in Group 1 after initiation of statin therapy for cholesterol (174.68 +/- 53.8 to 142 +/- 32.7, p < 0.05), Hgb (10.61 +/- 1.2 to 12.48 +/- 0.79, p < 0.0005), ferritin (618 +/- 334.1 to 334 +/- 265, p < 0.05), and albumin (3.58 +/- 0.4 to 3.77 +/- 0.4, p < 0.005). EPO requirements decreased by 25%. Mean values for lipid panel showed reductions in cholesterol (18%), triglyceride (37.8%), and low density lipoprotein (LDL) (26%), as well as elevation in high density lipoprotein (HDL) (11%). These data suggest that statin therapy may decrease EPO requirements in dialysis patients. The improvement in EPO responsiveness may be caused by the effect of statins on CRP.
Sirken
Gary
G
Albert Einstein Medical Center, Kraftsow Division of Nephrology, Philadelphia, Pennsylvania 19141, USA.
Kung
Shiang-Cheng
SC
Raja
Rasib
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism; D004351:Drug Resistance; D004921:Erythropoietin / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000097:blood / Q000188:drug therapy / Q000628:therapy; D008875:Middle Aged; D011994:Recombinant Proteins; D006435:Renal Dialysis; D012189:Retrospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011994:Recombinant Proteins; D004921:Erythropoietin; D002097:C-Reactive Protein