title: Anti-inflammatory interventions in end-stage kidney disease: a randomized, double-blinded, controlled and crossover clinical trial on the use of pravastatin in continuous ambulatory peritoneal dialysis.
abstract: OBJECTIVE
  Inflammation is highly prevalent in patients on dialysis. Statins have anti-inflammatory actions but their use has been scarcely studied in continuous ambulatory peritoneal dialysis (CAPD). We undertook this study to compare the effect of pravastatin vs. placebo on the serum concentrations of C-reactive protein (CRP) in patients on CAPD.
  
  
  METHODS
  In a double-blind, controlled and crossover clinical trial, 76 CAPD patients were randomized to either pravastatin or placebo for 2 months. After this first period of treatment, patients had a 1-month wash-out period and, finally, they were crossed-over to receive the other drug (or placebo) for 2 more months. Measurement of clinical and biochemical variables and CRP was performed at the beginning and at the end of each treatment period.
  
  
  RESULTS
  Median CRP was only significantly decreased in the pravastatin group in both periods of treatment: first period (baseline vs. final, mg/L): pravastatin 7.4 (2-21) vs. 2.6 (1-6), p <0.05; placebo 3.9 (2-10) vs. 6.8 (3-12), pNS; second period: pravastatin 4.3 (2-15) vs. 1.9 (1-7), p <0.05; placebo 4.9 (2-17) vs. 6.8 (2-19), p <0.05. Results were significantly different (p <0.05) between groups only at the end of each treatment period. Additionally, total and LDL-cholesterol significantly decreased in the pravastatin group.
  
  
  CONCLUSIONS
  Pravastatin significantly reduced serum levels of CRP and total and LDL-cholesterol compared to placebo. This treatment may be of great help to decrease the inflammatory status and probably the cardiovascular disease of CAPD patients.
authors.affiliation: Medical Research Unit Kidney Disease, Specialty Hospital, CMNO, Guadalajara, Mexico. Electronic address: a_cueto_manzano@hotmail.com.
authors.forename: Alfonso M
authors.initials: AM
authors.lastname: Cueto-Manzano
authors.forename: Juan R
authors.initials: JR
authors.lastname: Angel-Zúñiga
authors.forename: Gabina
authors.initials: G
authors.lastname: Ornelas-Carrillo
authors.forename: Enrique
authors.initials: E
authors.lastname: Rojas-Campos
authors.forename: Héctor R
authors.initials: HR
authors.lastname: Martínez-Ramírez
authors.forename: Laura
authors.initials: L
authors.lastname: Cortés-Sanabria
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage* / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000037:antagonists & inhibitors / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D008078:Cholesterol, LDL / Q000037:antagonists & inhibitors / Q000097:blood; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D007676:Kidney Failure, Chronic / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D010531:Peritoneal Dialysis, Continuous Ambulatory / Q000009:adverse effects; D010919:Placebos; D017035:Pravastatin / Q000008:administration & dosage* / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D008078:Cholesterol, LDL; D010919:Placebos; D002097:C-Reactive Protein; D017035:Pravastatin
keywords: C-reactive protein; Continuous ambulatory peritoneal dialysis; Crossover clinical trial; Inflammation; Pravastatin