Impact of statin treatment on 1-year functional and histologic renal allograft outcome.
BACKGROUND
Statins are antilipidemic agents that exhibit a variety of cellular effects independent of their lipid-lowering action. A retrospective study was undertaken to establish the impact of statins on graft outcome in the first year posttransplantation.


METHODS
Data from patients with uniform immunosuppression (cyclosporine, mycophenolate mofetil, and prednisolone) who underwent transplantation at the authors' unit from 1997 to 2002 were reviewed. Patients prescribed statins were compared with those not on a statin. Mean change in creatinine clearance (CrCl) from 3 to 12 months posttransplantation was calculated. Histomorphometric analysis was used to quantify fractional interstitial area and collagen III deposition in matched preperfusion and 12-month protocol biopsy specimens.


RESULTS
Seventy-seven patients met study criteria: statin, n=44 patients; nonstatin, n=33 patients. Median time to commencing a statin was 5 weeks. At 3 months, CrCl (+/-SEM) was similar: 51.6+/-2.9 mL/min (statin) versus 51.3+/-1 mL/min (nonstatin). At 12 months, the mean change in CrCl was 4.1+/-1 mL/min (statin) compared with -2.0+/-1.8 mL/min (nonstatin), resulting in a difference of 6.13 mL/min at 12 months (P<0.005). Mean preperfusion fractional interstitial areas were similar (23.9+/-1.6%; P=not significant [NS]). On 12-month biopsy specimens, the fractional interstitial area had increased to 34+/-3.2% in the nonstatin group (P<0.005), with no change in the statin group. Interstitial collagen III deposition was similar in preperfusion biopsy specimens (10.4+/-1%; P=NS), but at 12 months it was significantly greater in the nonstatin group (17.6+/-1%; P<0.05)


CONCLUSIONS
Early introduction of statins may be associated with improved 1-year graft outcome.
Masterson
Rosemary
R
Department of Nephrology, Royal Melbourne Hospital, Parkville, Melbourne, Victoria, Australia. rosemary.masterson@mh.org.au
Hewitson
Tim
T
Leikis
Murray
M
Walker
Rowan
R
Cohney
Shlomo
S
Becker
Gavin
G
D000328:Adult; D002784:Cholesterol / Q000378:metabolism; D024043:Collagen Type II / Q000737:chemistry; D003404:Creatinine / Q000097:blood; D005260:Female; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007668:Kidney / Q000187:drug effects* / Q000473:pathology; D007674:Kidney Diseases / Q000209:etiology / Q000517:prevention & control; D016030:Kidney Transplantation / Q000379:methods*; D050356:Lipid Metabolism; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D013997:Time Factors; D014184:Transplantation, Homologous / Q000379:methods; D016896:Treatment Outcome
D024043:Collagen Type II; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol; D003404:Creatinine