title: Statin use is associated with lower inflammation and erythropoietin responsiveness index in hemodialysis patients.
abstract: Patients with end-stage renal disease are prone to inflammation and inflammation is related to erythropoietin-stimulating agent hyporesponsiveness and mortality in this population. Statins have been demonstrated to reduce cardiovascular mortality in selected populations of end-stage renal disease patients. These drugs have pleiotrophic effects such as anti-inflammation. In this retrospective analysis, we determined whether the use of statins improves inflammation and inflammation-related anemia in a cohort of hemodialysis patients. Data were analyzed from Fresenius Medical Care Dialysis Clinics in Turkey between 2005 and 2007. Seventy prevalent hemodialysis patients who were on statins at the start of the study and have been on statins during follow-up (statin users) and 1293 patients who were not on statin at the start of the study and had never been prescribed any lipid-modifying drugs during follow-up (statin nonusers) were included in the study. High-sensitive C-reactive protein levels were significantly decreased in statin users (1.50±1.49 vs. 1.33±1.11 mg/L, P=0.05) compared with nonusers (1.93±3.22 vs. 2.05±2.77 mg/L). Hemoglobin levels and the rate of erythropoietin-stimulating agent users were similar. However, the prescribed erythropoietin-stimulating agent dose (31.6±27.5 vs. 47.3±45.2 U/kg/week, P<0.05) and the erythropoietin response index (2.90±2.73 vs. 4.51±4.48 U/kg/week/Hb, P=0.001) were lower in statin users compared with statin nonusers. On stepwise multiple regression analysis, gender, high-sensitive C-reactive protein, duration of hemodialysis, serum ferritin, and statin use were independent determinants of the erythropoietin responsiveness index. Our results suggest that statin treatment leads to lower inflammation and improves hematopoiesis in hemodialysis patients.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, Marmara University School of Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Koc
authors.forename: Cengiz
authors.initials: C
authors.lastname: Dogan
authors.forename: Turgay
authors.initials: T
authors.lastname: Arinsoy
authors.forename: Zeki
authors.initials: Z
authors.lastname: Tonbul
authors.forename: Deniz
authors.initials: D
authors.lastname: Ayli
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cirit
authors.forename: Mehmet Sukru
authors.initials: MS
authors.lastname: Sever
authors.forename: Mehmet Emin
authors.initials: ME
authors.lastname: Yilmaz
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Unsal
authors.forename: Gultekin
authors.initials: G
authors.lastname: Suleymanlar
authors.forename: Ercan
authors.initials: E
authors.lastname: Ok
authors.forename: Ali
authors.initials: A
authors.lastname: Basci
authors.forename: Alaatin
authors.initials: A
authors.lastname: Yildiz
mesh_terms: D000328:Adult; D000368:Aged; D004921:Erythropoietin / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006454:Hemoglobins; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007249:Inflammation / Q000097:blood / Q000401:mortality / Q000628:therapy; D007676:Kidney Failure, Chronic / Q000097:blood / Q000473:pathology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D012189:Retrospective Studies
chemical_list: D006454:Hemoglobins; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D004921:Erythropoietin