title: Effects of pitavastatin add-on therapy on chronic kidney disease with albuminuria and dyslipidemia.
abstract: BACKGROUND
  In non-dialysis chronic kidney disease (CKD) patients with dyslipidemia, statin therapy is recommended to prevent cardiovascular complications. Dyslipidemia has been also shown to be an independent risk factor for the progression of CKD. However, it is still unclear whether statin therapy exerts an inhibitory effect on renal deterioration in CKD patients with dyslipidemia. The purpose of the present study was to examine possible therapeutic effects of statin add-on therapy on renal function as well as parameters of lipid and glucose metabolism, arterial stiffness and oxidative stress, in comparison to diet therapy, in CKD patients with dyslipidemia.
  
  
  METHODS
  This study was a randomized, open-label, and parallel-group trial consisted of a 12-months treatment period in non-dialysis CKD patients with alubuminuria and dyslipidemia. Twenty eight patients were randomly assigned either to receive diet counseling alone (diet therapy group) or diet counseling plus pitavastatin (diet-plus-statin therapy group), to achieve the LDL-cholesterol (LDL-C) target of <100 mg/dl.
  
  
  RESULTS
  The statin treatment by pitavastatin was well tolerated in all of the patients without any significant adverse events and the average dose of pitavastatin was 1.0 ± 0.0 mg daily after treatment. After the 12-months treatment period, LDL-C was significantly lower in the diet-plus-statin therapy group compared with the diet therapy group (diet vs diet-plus-statin: LDL-C, 126 ± 5 vs 83 ± 4 mg/dL, P < 0.001). On the other hand, the diet-plus-statin therapy did not significantly reduce albuminuria or delay the decline in eGFR compared with the diet therapy, and there was no relationship between the change in LDL-C and the change in eGFR or albuminuria. However, diet therapy as well as diet-plus-statin therapy exerted similar lowering effects on the pentosidine levels (diet therapy group, baseline vs 12 months: 40 ± 4 vs 24 ± 3 ng/mL, P = 0.001; diet-plus-statin therapy, 46 ± 7 vs 34 ± 6 ng/mL, P = 0.008). Furthermore, the results of multivariate regression analysis indicated that the change in pentosidine was a significant contributor to the change in eGFR (β = -0.536, P = 0.011).
  
  
  CONCLUSIONS
  Although statin add-on therapy did not show additive renal protective effects, the diet therapy as well as the diet-plus-statin therapy could contribute to the reduction in plasma pentosidine in CKD patients with albuminuria and dyslipidemia.
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. mohsawa@yokohama-cu.ac.jp.|Department of Nephrology, Yokohama Hodogaya Central Hospital, Yokohama, 240-8585, Japan. mohsawa@yokohama-cu.ac.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Ohsawa
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. tamukou@med.yokohama-cu.ac.jp.
authors.forename: Kouichi
authors.initials: K
authors.lastname: Tamura
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. hiro1234@yokohama-cu.ac.jp.
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Wakui
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. to_kana8@yahoo.co.jp.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Kanaoka
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. azushima@yokohama-cu.ac.jp.
authors.forename: Kengo
authors.initials: K
authors.lastname: Azushima
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. k_uneda@yokohama-cu.ac.jp.
authors.forename: Kazushi
authors.initials: K
authors.lastname: Uneda
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. t106048f@yokohama-cu.ac.jp.
authors.forename: Sona
authors.initials: S
authors.lastname: Haku
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. t136034d@yokohama-cu.ac.jp.
authors.forename: Ryu
authors.initials: R
authors.lastname: Kobayashi
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. t146017e@yokohama-cu.ac.jp.
authors.forename: Kohji
authors.initials: K
authors.lastname: Ohki
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. kspring00712@gmail.com.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Haruhara
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. ja472t@bma.biglobe.ne.jp.
authors.forename: Sho
authors.initials: S
authors.lastname: Kinguchi
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. ystoya@yokohama-cu.ac.jp.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Toya
authors.affiliation: Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan. umemuras@med.yokohama-cu.ac.jp.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: D000368:Aged; D000419:Albuminuria / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy* / Q000473:pathology; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D001120:Arginine / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000037:antagonists & inhibitors / Q000097:blood; D004032:Diet / Q000379:methods*; D050171:Dyslipidemias / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005919:Glomerular Filtration Rate; D017127:Glycation End Products, Advanced / Q000037:antagonists & inhibitors / Q000097:blood; D006801:Humans; D008239:Lysine / Q000031:analogs & derivatives / Q000037:antagonists & inhibitors / Q000097:blood; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress / Q000187:drug effects; D011804:Quinolines / Q000627:therapeutic use*; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000178:diet therapy / Q000188:drug therapy* / Q000473:pathology; D014280:Triglycerides / Q000097:blood; D059289:Vascular Stiffness / Q000187:drug effects
chemical_list: D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D017127:Glycation End Products, Advanced; D011804:Quinolines; D014280:Triglycerides; D001120:Arginine; C062187:pentosidine; D008239:Lysine; C108475:pitavastatin