title: Do statins play a role in renoprotection?
abstract: Chronic kidney disease (CKD) is not merely a disorder featuring renal dysfunction, but also accelerates the progression of cardiovascular disease. Recently, the prevalence of CKD has been increasing in parallel with that of metabolic syndrome, suggesting that these two disorders are closely related. Metabolic syndrome is generally characterized by several metabolic and cardiovascular features, including obesity, insulin resistance and hypertension, all of which are known to cause renal impairment. Hence, it is likely that metabolic syndrome could be a key factor in the development of renal disease. Among several factors associated with metabolic syndrome, lipid abnormality, in particular a high level of serum low-density lipoprotein, has been emerging as a cause of kidney injury. Accumulating evidence has demonstrated that statin therapy for treating hyperlipidemia could slow the progression of renal disease, indicating that a treatment for lipid abnormality might prevent the progression of renal disease. In other words, statin therapy might be renoprotective in addition to its beneficial effect on the cardiovascular system. We are carrying out a clinical trial, the ASUCA trial, in which we examine whether statins might slow the progression of CKD in the Japanese population. We organized the multi-center clinical trial to investigate the effect of atorvastatin on estimated glomerular filtration rate in patients with CKD and lipid abnormality. In this paper, we discuss the outline and significance of this trial.
authors.affiliation: Department of EBM Research, Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan, kasa@kuhp.kyoto-u.ac.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Kasahara
authors.forename: Takahiko
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Yokoi
authors.forename: Takashige
authors.initials: T
authors.lastname: Kuwabara
authors.forename: Shinji
authors.initials: S
authors.lastname: Yasuno
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Mori
authors.forename: Masashi
authors.initials: M
authors.lastname: Mukoyama
authors.forename: Kenji
authors.initials: K
authors.lastname: Ueshima
mesh_terms: D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000209:etiology; D000818:Animals; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D059305:Diet, High-Fat / Q000009:adverse effects; D018450:Disease Progression; D006538:Heptanoic Acids / Q000009:adverse effects; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007668:Kidney / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications; D008875:Middle Aged; D011758:Pyrroles / Q000009:adverse effects; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000517:prevention & control*
chemical_list: D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D000069059:Atorvastatin