The effects of statins on the progression of atherosclerotic renovascular disease.
OBJECTIVE
The aim was to examine the influence of statin therapy on the natural history of atherosclerotic renal artery stenosis (RAS).


METHODS
Our hospital atherosclerotic renovascular disease (ARVD) database was analysed for patients who underwent repeat renal angiography during clinical follow-up. Patients with >or=1 RAS lesion and >or=4 months between baseline and repeat renal angiography were analysed. 79 patients were included. Baseline renal arterial anatomy was classified as normal, <or=50% RAS, >50% RAS or renal artery occlusion.


RESULTS
Mean follow-up time between angiograms was 27.8 +/- 22.3 (4.0-101.9) months. Progression of RAS occurred in 28 (23%) vessels, regression in 14 (12%) and no significant change in 79 (65%). Multivariate regression analysis showed that baseline proteinuria >0.6 g/day increased the risk of progressive disease (relative risk, RR, 3.8; 95% confidence interval, CI, 1.2-12.1), treatment with statin reduced the risk of progression (RR 0.28; 95% CI 0.10-0.77). 14 renal arteries from 12 patients showed RAS regression with a greater proportion on statin [statin treatment 10 (83%) versus no statin treatment 2 (17%), p = 0.001]. Change in estimated glomerular filtration rate (eGFR) per year was not different between statin- and no-statin-treated groups.


CONCLUSIONS
Progression or development of RAS was significantly less likely to occur with statin therapy. Delta eGFR did not correlate with progression of RAS, reflecting the importance of intrarenal injury in the aetiology of renal dysfunction. Our results suggest statin therapy can alter the natural history of ARVD.
Cheung
Ching M
CM
Department of Renal Medicine, Hope Hospital, Salford, UK. Ching.Cheung@srht.nhs.uk
Patel
Amit
A
Shaheen
Nilam
N
Cain
Sharon
S
Eddington
Helen
H
Hegarty
Janet
J
Middleton
Rachel J
RJ
Cowie
Alistair
A
Mamtora
Hari
H
Kalra
Philip A
PA
D000328:Adult; D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007674:Kidney Diseases / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors