title: Renoprotective effects of atorvastatin compared with pravastatin on progression of early diabetic nephropathy.
abstract: BACKGROUND
  Several studies have shown that statins suppress the progression of diabetic nephropathy. However, few reports have directly compared the renoprotective effects between potent and conventional statins.
  
  
  METHODS
  Patients with diabetic nephropathy, selected as those with a serum creatinine level of 0.9-1.5 mg/dL and simultaneously having either microalbuminuria or positive proteinuria, were randomly assigned to one of three groups: a conventional diet therapy group, a group given 10 mg of pravastatin and a group given 10 mg of atorvastatin. Renal function was evaluated before and after a 12-month period of therapy.
  
  
  RESULTS
  The atorvastatin group had a significant decrease in low-density lipoprotein cholesterol at 3 months and thereafter compared with the other groups. The urinary albumin-to-creatinine ratio significantly decreased in the atorvastatin group; the degree of this decrease was significantly greater than that in the diet therapy group. The kidney function estimated with cystatin C (CysC) and the estimated glomerular filtration rate calculated from CysC were significantly preserved in the atorvastatin group compared with the pravastatin group. In a multivariate regression analysis, the use of atorvastatin was the only explanatory variable for the changes in CysC; this was independent of changes in low-density lipoprotein cholesterol.
  
  
  CONCLUSIONS
  Atorvastatin is more effective than pravastatin for the prevention of increase in CysC, and this renoprotective effect was considered to a result of the pleiotropic effect of atorvastatin independent of its lipid-lowering effect. This study was registered with UMIN (no. UMIN 000001774).
authors.affiliation: Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Sciences Kanazawa, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Takazakura
authors.affiliation: Department of Epidemiology and Public Health, Kanazawa Medical University Uchinada, Ishikawa, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Sakurai
authors.affiliation: Department of Internal Medicine, Fukui-ken Saiseikai Hospital Fukui, Fukui, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Bando
authors.affiliation: Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Sciences Kanazawa, Japan ; Department of Comprehensive Metabology, Kanazawa University Graduate School of Medical Sciences Kanazawa, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Misu
authors.affiliation: Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Sciences Kanazawa, Japan.
authors.forename: Yumie
authors.initials: Y
authors.lastname: Takeshita
authors.affiliation: Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Sciences Kanazawa, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Kita
authors.affiliation: Department of Internal Medicine, Toyama City Hospital Toyama, Toyama, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Shimizu
authors.affiliation: Department of Internal Medicine, Toyama City Hospital Toyama, Toyama, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Hayakawa
authors.affiliation: Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Sciences Kanazawa, Japan.
authors.forename: Ken-Ichiro
authors.initials: K
authors.lastname: Kato
authors.affiliation: Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Sciences Kanazawa, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Kaneko
authors.affiliation: Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Sciences Kanazawa, Japan ; Department of Comprehensive Metabology, Kanazawa University Graduate School of Medical Sciences Kanazawa, Japan.
authors.forename: Toshinari
authors.initials: T
authors.lastname: Takamura
keywords: Early diabetic nephropathy; Renoprotective effects; Statins