Effects of statins on renal function.
Patients with chronic kidney disease (CKD) are much more likely to die of cardiovascular disease than end-stage renal disease. Dyslipidemia is highly prevalent in patients with CKD and may contribute to the elevated cardiovascular risk as well as CKD progression. Statins are lipid-lowering drugs that appear to protect the kidneys via cholesterol reduction as well as noncholesterol-mediated mechanisms. Subgroup analyses of major clinical studies and meta-analyses of smaller trials indicate that statin therapy slows the decline of the glomerular filtration rate. Additionally, statins appear to reduce proteinuria in patients with CKD. Statins are well recognized to reduce cardiovascular morbidity and mortality in patients with and without documented cardiovascular disease and in certain high-risk populations, such as persons with diabetes mellitus. However, conclusive evidence for improved cardiovascular outcomes with statin therapy for CKD is not yet available. Several ongoing studies are evaluating the effect of statins on cardiovascular end points in patients with CKD and may provide data needed to support adjunctive use of these agents in this high-risk population.
Agarwal
Rajiv
R
Indiana University School of Medicine, Richard L. Roudebush [corrected] VA Medical Center, 1481 W Tenth St (111N), Indianapolis, IN 46202, USA.
D002318:Cardiovascular Diseases; D002908:Chronic Disease; D018450:Disease Progression; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy; D050556:Fatty Acid-Binding Proteins / Q000187:drug effects; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D007668:Kidney / Q000187:drug effects*; D007674:Kidney Diseases / Q000150:complications*; D016030:Kidney Transplantation; D011507:Proteinuria / Q000188:drug therapy
C493319:FABP1 protein, human; D050556:Fatty Acid-Binding Proteins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors