[Effects of statins on delaying progression of chronic kidney disease: a meta-analysis].
OBJECTIVE
Whether statins can slow down the progression of chronic kidney disease (CKD) remains controversial. We performed a meta-analysis to evaluate the effects of statin therapy on disease progression in adult patients with CKD who did not require dialysis therapy.


METHODS
We searched the electronic databases for relevant randomized controlled trials (RCTs) published by February 2015. Random-effects meta-analysis of RCTs was used to pool the renal outcomes of the patients.


RESULTS
Twenty-eight studies (30 RCTs) involving a total of 45 688 participants were included in the analysis. Compared with the control groups, statins produced no effects in preventing end-stage renal disease (ESRD) [relative risks (RR) 0.98, 95% confidence intervals (CI): 0.91-1.05] and in reducing the risk of doubling of the serum creatinine level (RR 1.43, 95% CI: 0.26-7.79). Statin therapy was associated with a lowered risk of estimated glomerular filtration rate (eGFR) reduction by 25% or more (RR 0.91, 95% CI: 0.83-0.99) and delayed the reduction of eGFR [standardized mean differences (SMD) 0.04, 95% CI: 0.02-0.07]. In subgroup analyses, the benefit of statins on changes in eGFR was statistically significant in patients with moderate CKD (SMD 0.09, 95% CI 0.04-0.13). Among different statins, atorvastatin was associated with a beneficial effect on kidney function (SMD 0.10, 95% CI 0.03-0.17). Patients who received high-intensity statin therapy showed significant changes in eGFR (SMD 0.12, 95% CI: 0.02-0.21).


CONCLUSIONS
Statin therapies may not prevent ESRD or doubling of serum creatinine level, but can improve GFR or delay the reduction of GFR in CKD patients. The therapeutic effects are associated with the patients' baseline eGFR levels, statin types and therapy intensity.
Department of Nephrology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China. E-mail: liuzongruihao@126.com.
Zong-Rui
ZR
Liu
Hao
H
Zhao
Yan-Rong
YR
Chen
Dong-Dong
DD
Tang
Hong-Xin
HX
Niu
D000328:Adult; D018450:Disease Progression; D005919:Glomerular Filtration Rate; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007676:Kidney Failure, Chronic / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D051436:Renal Insufficiency, Chronic / Q000188:drug therapy*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors