Effect of Statins on the Progression of Coronary Calcification in Kidney Transplant Recipients.
BACKGROUND
Coronary calcification (CAC) is highly prevalent in kidney transplant recipients (KTRs) and has been associated with cardiovascular morbidity and mortality. Some studies have shown a reduction in CAC progression with statin therapy in the general and chronic kidney disease (CKD) populations.


OBJECTIVE
The aim of the present study was to evaluate the effect of statins on CAC progression in incident kidney transplant recipients. Patients were randomly assigned to the statin (n = 61, 10 mg daily) and control group (n = 59). CAC and biochemical analyses were performed at baseline and 12 months.


RESULTS
At baseline, CAC was observed in 30% and 21% of patients in the statin and control groups, respectively (p = 0.39). The calcium score at baseline and its absolute and relative changes over 12 months of follow up were similar among the groups. In the statin group, total cholesterol (p < 0.001), low density lipoprotein cholesterol (p < 0.001) and triglycerides (p = 0.005) decreased, and the estimated glomerular function rate increased (p<0.001) significantly. CRP levels remained stable (p = 0.52) in the statin group but increased in the control group (p = 0.01). In the multivariate model, there was no difference in CAC progression between the groups (group effect p = 0.034; time-effect p = 0.23; interaction p = 0.74). Similar results were obtained when only patients with ≥ 10AU calcium score (calcified) were analyzed (group effect p = 0.051; time-effect p = 0.58; interaction p = 0.99).


CONCLUSIONS
Although statins reduce the levels of cholesterol, triglycerides, inflammation and improve graft function, the dose adopted in the current study did not delay CAC progression within 12 months of follow up.


BACKGROUND
Brazilian Clinical Trials Registry RBR-32RFMB.
Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil.
Daniel Constantino
DC
Yazbek
Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil.
Aluizio Barbosa
AB
de Carvalho
Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil.
Cinara Sá
CS
Barros
Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil.
Jose Osmar
JO
Medina Pestana
Nephrology Division, Federal University of São Paulo, São Paulo, SP, Brazil.
Maria Eugênia F
ME
Canziani
D000328:Adult; D002113:Calcification, Physiologic / Q000187:drug effects*; D002114:Calcinosis / Q000188:drug therapy*; D002784:Cholesterol / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000209:etiology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016030:Kidney Transplantation / Q000379:methods; D008297:Male; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications; D066027:Transplant Recipients; D014280:Triglycerides / Q000378:metabolism
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D002784:Cholesterol