title: Statin improves flow-mediated vasodilation in chronic kidney diseases.
abstract: Background. Numbers of drugs are required to manage patients with chronic kidney disease (CKD). Drug adherence is relatively poor in this population. Methods. In 36 CKD patients with hypertension and dyslipidemia, who were prescribing amlodipine 5 mg and atorvastatin 10 mg daily, the influences of exchanging to a combination drug containing equivalent doses of amlodipine and atorvastatin were observed for 6 months. Results. At the baseline, flow-mediated dilation (FMD) was reduced (2.4 ± 0.3%), and proteinuria was significantly contributed to decrements of FMD (R (2) = 0.38, F = 3.7, df (6,29), and  P < 0.01). Six months later from exchanging to combination drug, total cholesterol (TC, 197 ± 5 to 183 ± 3 mg/dL,  P < 0.01) and triglycerides (142 ± 14 to 129 ± 10 mg/dL, P < 0.05) were decreased, but high density lipoprotein cholesterol (53 ± 3 to 56 ± 3 mg/dL, P < 0.05) was increased. FMD was slightly albeit significantly improved to 2.7 ± 0.3% (P < 0.05). No serious adverse effects were seen by the combination drug. Subanalysis for the patients with considerable reductions of TC demonstrated that the combination drug decreased proteinuria and high sensitive CRP (P < 0.05 for both). Conclusion. Our data indicate that proteinuria constitutes a determinant of a reduced FMD. The present results implicate that combination drug is useful to improve adherence and suggest that atorvastatin refines endothelium function as well as lipid profiles in CKD patients.
authors.affiliation: International University of Health and Welfare, Clinical Research Center, Sanno Hospital, 8-10-16 Akasaka, Minato, Tokyo 107-0052, Japan ; Saitama Medical University, Department of Nephrology, 36 Morohongo, Moroyama, Iruma, Saitama 350-0495, Japan.
authors.forename: Tsuneo
authors.initials: T
authors.lastname: Takenaka
authors.affiliation: Saitama Medical University, Department of Nephrology, 36 Morohongo, Moroyama, Iruma, Saitama 350-0495, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Takane
authors.affiliation: Saitama Medical University, Department of Nephrology, 36 Morohongo, Moroyama, Iruma, Saitama 350-0495, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kikuta
authors.affiliation: Saitama Medical University, Department of Nephrology, 36 Morohongo, Moroyama, Iruma, Saitama 350-0495, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Watanabe
authors.affiliation: Saitama Medical University, Department of Nephrology, 36 Morohongo, Moroyama, Iruma, Saitama 350-0495, Japan.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Suzuki