title: Efficacy of statins in patients with diabetic nephropathy: a meta-analysis of randomized controlled trials.
abstract: BACKGROUND
  The effects of statins in patients with diabetic nephropathy are controversial. With increasing interest in the potential therapeutic role of statins in diabetic nephropathy, it is essential to evaluate its real effects.
  
  
  METHODS
  PubMed, EMBASE, Web of Science databases, Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure were systematically searched for randomized controlled trials (RCTs) of statins in patients with diabetic nephropathy.
  
  
  RESULTS
  Fourteen trials with 2866 participants were included in our meta-analysis. Compared with placebo, albuminuria and urinary albumin excretion rates in the statin group were reduced by 0.46 [95 % confidence interval (CI),-0.68 to -0.25, P < 0.0001] and 1.68 (95 % CI, -3.23 to -0.12, P = 0.03), respectively. The reduction of albuminuria was greater in patients of type 2 diabetes mellitus with diabetic nephropathy [standardized mean difference (SMD), -0.56; 95 % CI, -0.80 to -0.32, P < 0.00001] and the decrease was significant during the 1 to 3 years period of statin therapy (SMD, -0.57; 95 % CI, -0.95 to -0.19, P = 0.003). Subgroup analysis demonstrated the effects of statins were much stronger in subjects with pathologic albuminuria: change of -0.71 (95 % CI, -1.09 to -0.33, P = 0.0003) for those with urinary protein excretion 30 to 300 mg/day, -0.37 (95 % CI, -0.67 to -0.06, P = 0.02) for those with excretion more than 300 mg/day and -0.29 (95 % CI, -0.78 to 0.21, P = 0.26) for those with excretion less than 30 mg/day. In contrast, statins did not significantly reduce estimated glomerular filtration rate, serum creatinine and blood urea nitrogen levels.
  
  
  CONCLUSIONS
  Statins decrease the albuminuria and urinary albumin excretion rates significantly. The efficacy of statins on renal function is time dependent and better in type 2 diabetic patients with nephropathy.
authors.affiliation: Department of Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University of Traditional Chinese Medicine, Jinan, 250014, China.
authors.forename: Xue
authors.initials: X
authors.lastname: Shen
authors.affiliation: Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China.
authors.forename: Zhongwen
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China.
authors.forename: Xiaoqian
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China.
authors.forename: Junyu
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China.
authors.forename: Xiaojun
authors.initials: X
authors.lastname: Zhou
authors.affiliation: Department of Medicine, Shandong Provincial Qianfoshan Hospital, Shandong University of Traditional Chinese Medicine, Jinan, 250014, China.
authors.forename: Qinglei
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China.
authors.forename: Hongxia
authors.initials: H
authors.lastname: Shang
authors.affiliation: Department of Medicine, Division of Endocrinology, Qilu Hospital of Shandong University, Jinan, 250012, China.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Dong
authors.affiliation: Department of Medicine, Division of Endocrinology, Shandong Provincial Qianfoshan Hospital, Shandong University, No.16766, Jingshi Road, Lixia District, Jinan, 250014, Shandong Province, China. liaolin009@sina.com.
authors.forename: Lin
authors.initials: L
authors.lastname: Liao
mesh_terms: D000419:Albuminuria / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D001806:Blood Urea Nitrogen; D003404:Creatinine / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D003928:Diabetic Nephropathies / Q000188:drug therapy* / Q000503:physiopathology / Q000652:urine; D005919:Glomerular Filtration Rate; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D003404:Creatinine
keywords: Diabetic Nephropathy; Meta-analysis; Statins