Impact of managing atherogenic dyslipidemia on cardiovascular outcome across different stages of diabetic nephropathy.
BACKGROUND
The prevalence of chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM) is increasing. In turn, both CKD and T2DM are associated with increased risk of vascular events and progression to end-stage kidney disease (ESKD). In patients with DM, statin treatment can significantly improve estimated glomerular filtration rate (eGFR) or delay eGFR decline as well as significantly reduce CVD morbidity and mortality. In contrast, statins do not seem to decrease events in patients with advanced decline in kidney function.


METHODS
This review considers the effects of statins and other lipid lowering drugs on kidney function and vascular events in patients with CKD and T2DM.


RESULTS
Greater awareness of the links between CKD, T2DM, kidney function and vascular risk as well as the role of lipid-lowering drugs (mainly statins) in this field.


CONCLUSIONS
Current evidence points towards the need to prescribe statins in patients with T2DM before a major decline in kidney function occurs.
Athyros
Vasilios G
VG
Second Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, Hippocration Hospital, Medical School, Thessaloniki, Greece.
Mitsiou
Eydoxia K
EK
Tziomalos
Konstantinos
K
Karagiannis
Asterios
A
Mikhailidis
Dimitri P
DP
D050197:Atherosclerosis / Q000150:complications / Q000188:drug therapy; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003928:Diabetic Nephropathies / Q000150:complications*; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy*; D005919:Glomerular Filtration Rate; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000150:complications; D012720:Severity of Illness Index
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents