title: Effects of atorvastatin on renal function in patients with dyslipidemia and chronic kidney disease: assessment of clinical usefulness in CKD patients with atorvastatin (ASUCA) trial.
abstract: BACKGROUND
  Dyslipidemia is a risk factor for the progression of chronic kidney disease (CKD). While conventional lipid lowering therapy provides a benefit to CKD management, the effect of statins on eGFR remains unclear.
  
  
  METHODS
  A prospective, multi-center, open-labeled, randomized trial. Total of 349 CKD patients with hyperlipidemia were randomized into 2 groups, and followed for 2 years. Group A included patients who were treated with atorvastatin. Group C were treated with conventional lipid lowering drugs other than statin. Primary endpoint was changes in eGFR. Secondary endpoints included changes in urinary albumin excretion, serum LDL-C, serum triglyceride, cardio-vascular events and all-cause mortality.
  
  
  RESULTS
  As the primary endpoint, eGFR decreased by 2.3 ml/min/1.73 m2in Group A and by 2.6 ml/min/1.73 m2in Group C, indicating that there was no difference in change of eGFR between the two groups. As secondary endpoints, atorvastatin succeeded to reduce serum LDL-C level significantly and rapidly, but conventional therapy did not. In fact, mean LDL-C level did not reach the target level of 100 mg/dl in Group C. Serum triglyceride was lowered only by atorvastatin, but not conventional drugs. The number of cardiovascular events and all-cause mortality did not differ between in two groups.
  
  
  CONCLUSIONS
  The ASUCA (Assessment of Clinical Usefulness in CKD Patients with Atorvastatin) trial demonstrated that atorvastatin failed to exhibit reno-protections compared to conventional therapy in Japanese patients with dyslipidemia and CKD. It would be due in part to the ability of atorvastatin to more potently reduce serum LDL and triglycerides compared to conventional therapy.
authors.affiliation: Asahi Rosai Hospital, Owariasahi, Aichi, Japan.
authors.forename: Genjiro
authors.initials: G
authors.lastname: Kimura
authors.affiliation: Department of EBM Research, Institute of Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan. kasa@naramed-u.ac.jp.|Institute for Clinical and Translational Science, Nara Medical University Hospital, 840 Shijo-cho, Kashihara, Nara, Japan. kasa@naramed-u.ac.jp.
authors.forename: Masato
authors.identifier: http://orcid.org/0000-0002-1833-9075
authors.initials: M
authors.lastname: Kasahara
authors.affiliation: Department of EBM Research, Institute of Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ueshima
authors.affiliation: Department of EBM Research, Institute of Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of EBM Research, Institute of Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Yasuno
authors.affiliation: Department of EBM Research, Institute of Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Fujimoto
authors.affiliation: Department of Biostatistics, Kyoto University School of Public Health, Kyoto, Japan.
authors.forename: Toshiya
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Food and Nutritional Science, Kobe Women's Junior College, Kobe, Japan.
authors.forename: Miyuki
authors.initials: M
authors.lastname: Imamoto
authors.affiliation: Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Kosugi
authors.affiliation: Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Kazuwa
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000328:Adult; D000368:Aged; D000069059:Atorvastatin / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000401:mortality; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007564:Japan; D007668:Kidney / Q000187:drug effects* / Q000503:physiopathology; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000401:mortality / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D000069059:Atorvastatin
keywords: Chronic kidney disease (CKD); Hyperlipidemia; Low-density lipoprotein cholesterol (LDL-C); Reno-protective effect; Statins