Effect of statins on erythropoietin responsiveness in type 2-diabetic versus non-diabetic hemodialysis patients.
OBJECTIVE
This study investigated whether the antiinflammatory effect of statins improved erythropoietin responsiveness in hemodialysis patients. We also examined if Type 2 diabetes mellitus, which had been shown to increase erythropoietin resistance, affected this effect of statins.


METHODS
103 patients were included in the cross-sectional study. Patients were stratified into statin and non-statin groups, and subgrouped based on the presence of Type 2 diabetes mellitus. Demographic, laboratory and other relevant data were analyzed by independent sample t-tests. The outcome of interest was erythropoietin dose. Two-way analysis of variance was used to determine the interaction between the use of statins and the presence of Type 2 diabetes mellitus.


RESULTS
Of 103 patients, 34% were on statins and 38.8% were diabetic. The mean erythropoietin dose (units/kg per week) was significantly lower in the statin group (275.6 +/- 273.2, 449.5 +/- 555.9, p < 0.05). 20% of patients in the statin group required erythropoietin dose in excess of an epoetin equivalent of 500 units/kg per week, compared to 30.88% in the non-statin group. The mean C-reactive protein level (mg/l) was lower in the statin group, although there was no statistical significance (1.13 +/- 1.22, 1.77 +/- 2.43, p = 0.08). The two-way analysis of variance showed no interaction between the use of statins and the presence of Type 2 diabetes mellitus on erythropoietin dose.


CONCLUSIONS
Our study demonstrated that hemodialysis patients who were on statins had a significantly lower erythropoietin requirement. This association is possibly due to the pleiotropic effect of statins.
Tangdhanakanond
K
K
Department of Internal Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA. kawin4180759@hotmail.com
Raja
R
R
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D004334:Drug Administration Schedule; D004347:Drug Interactions; D004921:Erythropoietin / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D018579:Patient Selection; D011994:Recombinant Proteins; D006435:Renal Dialysis; D012189:Retrospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011994:Recombinant Proteins; D004921:Erythropoietin; D002097:C-Reactive Protein