The acute effect of atorvastatin on proteinuria in patients with chronic glomerulonephritis.
BACKGROUND
Hyperlipidemia may develop early in the course of renal disease, and statin treatment to lower lipid levels in these patients is effective. In addition, it has been suggested that proteinuria may decrease after prolonged periods of statin treatment. In the present study, we set out to evaluate the short-term effect of atorvastatin after only six weeks of therapy.


METHODS
Plasma albumin, creatinine, creatinine clearance, proteinuria and lipid profiles were assessed in 31 consecutive patients with glomerulonephritis and proteinuria > 0.3 g/24 h. All patients were treated with ACE inhibition for more than three months. Twenty patients consented to receive additional treatment with atorvastatin 10 mg daily in conjunction with a cholesterol-reducing diet, while 11 patients received standard care. Analyses were performed at baseline and after six weeks.


RESULTS
After six weeks of treatment with atorvastatin urinary protein excretion was reduced from 1.80 g/24 h to 1.42 g/24 h (22%, p = 0.005), while no change was observed in this parameter in the untreated patients over the same period. Plasma albumin did not change in treated or in untreated patients. Lipid and lipoprotein parameters improved in all treated patients (all p < 0.001). No correlation was observed between the percentual changes in lipids and proteinuria. Plasma creatinine and creatinine clearance did not change (p > 0.05).


CONCLUSIONS
Six weeks of therapy with low-dose atorvastatin, added to ACE inhibition, resulted in a 22% decrease of proteinuria compared to untreated patients.
Ozsoy
R C
RC
Department of Nephrology, The Academic Medical Center, University of Amsterdam, The Netherlands.
Koopman
M G
MG
Kastelein
J J P
JJ
Arisz
L
L
D000328:Adult; D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood / Q000652:urine; D002784:Cholesterol / Q000097:blood; D002908:Chronic Disease; D003404:Creatinine / Q000097:blood / Q000652:urine; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007328:Insulin / Q000097:blood; D049528:Insulin, Long-Acting; D061386:Insulin, Regular, Human; D008074:Lipoproteins / Q000097:blood; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D011758:Pyrroles / Q000008:administration & dosage / Q000627:therapeutic use*; D012189:Retrospective Studies; D012709:Serum Albumin; D000075462:Serum Albumin, Human; D013997:Time Factors; D016896:Treatment Outcome
C499251:Albulin; D000924:Anticholesteremic Agents; D015415:Biomarkers; D006538:Heptanoic Acids; D007328:Insulin; D049528:Insulin, Long-Acting; D061386:Insulin, Regular, Human; D008074:Lipoproteins; D011758:Pyrroles; D012709:Serum Albumin; D002784:Cholesterol; D000069059:Atorvastatin; D003404:Creatinine; D000075462:Serum Albumin, Human