title: Effect of rosuvastatin and sevelamer on the progression of coronary artery calcification in chronic kidney disease: a pilot study.
abstract: BACKGROUND
  Coronary artery calcification (CAC) is highly prevalent among chronic kidney disease (CKD) patients and its strong association with mortality has been recognized early in the course of CKD. The aim of the present study was to test the effect of rosuvastatin and sevelamer hydrochloride on the progression of CAC in nondialyzed CKD patients.
  
  
  METHODS
  An open-label, randomized and controlled pilot study was conducted including 117 CKD patients (62% men, 56.9 ± 11.2 years, eGFR 36 ± 16.5 ml/min). Patients were randomly assigned to rosuvastatin (n = 38; 10 mg/day), to sevelamer hydrochloride (n = 38; 2,400 mg/day) and to control (n = 41) groups. CAC (by multislice computed tomography) and biochemical analyses were performed at baseline and after 24 months.
  
  
  RESULTS
  At baseline, CAC was observed in 55%, 58% and 61% of patients in the rosuvastatin, sevelamer hydrochloride and control groups, respectively (p = 0.87). Calcium score at baseline as well as its absolute and relative changes during 24 months were similar among the groups. Low density lipoprotein cholesterol (LDL-c) was higher and decreased significantly in the rosuvastatin group (p < 0.01). The analysis adjusting for LDL-c showed that the drug regimens were not associated with the progression of CAC (drug effect p = 0.85; time-effect p < 0.001; interaction p = 0.76).
  
  
  CONCLUSIONS
  Treatment with rosuvastatin and sevelamer hydrochloride may not delay the progression of CAC in non-dialysis dependent CKD patients.
authors: Department of Internal Medicine, Federal University of Sao Paulo, Sao Paulo, Brazil.
authors: Marcelo M
authors: MM
authors: Lemos
authors: Renato
authors: R
authors: Watanabe
authors: Aluízio B
authors: AB
authors: Carvalho
authors: Alessandra D B
authors: AD
authors: Jancikic
authors: Fabiana M R
authors: FM
authors: Sanches
authors: Dejaldo M
authors: DM
authors: Christofalo
authors: Sérgio A
authors: SA
authors: Draibe
authors: Maria Eugênia F
authors: ME
authors: Canziani
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002114:Calcinosis / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002614:Chelating Agents / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000188:drug therapy*; D018450:Disease Progression; D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011073:Polyamines / Q000627:therapeutic use*; D011743:Pyrimidines / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic / Q000150:complications*; D000068718:Rosuvastatin Calcium; D000069603:Sevelamer; D013449:Sulfonamides / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D002614:Chelating Agents; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011073:Polyamines; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D000069603:Sevelamer