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Published on: November 10, 2017
Effect of simvastatin on the lipid profile of hemodialysis patients
O Nishikawa1, M Mune, M Miyano
1Shouseikai Nishide Hospital, Kaizuka, Japan.
Insights
Simvastatin effectively lowers cholesterol in hemodialysis patients, reducing total cholesterol and LDL-C without significant side effects. This study indicates simvastatin is a safe and effective treatment for hypercholesterolemia in this population.
Area of Science:
- Nephrology
- Cardiovascular Medicine
- Pharmacology
Background:
- Simvastatin, a HMG-CoA reductase inhibitor, is widely used for hypercholesterolemia.
- Dyslipidemia is common in hemodialysis (HD) patients, but long-term simvastatin safety data is limited.
- This study investigated simvastatin's effects and safety on lipoprotein metabolism in hypercholesterolemic HD patients.
Purpose of the Study:
- To evaluate the efficacy and safety of simvastatin in treating hypercholesterolemia in hemodialysis patients.
- To assess the impact of simvastatin on lipoprotein metabolism, including various lipid fractions and apolipoproteins.
- To determine the incidence of adverse effects associated with long-term simvastatin use in this patient group.
Main Methods:
- 38 hypercholesterolemic HD patients received simvastatin 5 mg/day for 24 weeks.
- Serum lipids, apolipoproteins, Lp(a), and MDA were measured every four weeks.
- Lipid levels in lipoprotein fractions were analyzed via ultracentrifugation.
Main Results:
- Simvastatin significantly decreased total cholesterol (25.7%) and LDL-C (33.6%).
- Apolipoprotein B and E levels were significantly reduced; no significant changes in triglycerides or HDL-C.
- Malondialdehyde levels decreased, while Lp(a) remained unchanged. No adverse effects were reported.
Conclusions:
- Simvastatin demonstrates safety and efficacy in managing hypercholesterolemia in hemodialysis patients.
- The drug positively impacts lipoprotein metabolism by reducing atherogenic lipid fractions.
- Further long-term studies may be warranted, but initial findings support simvastatin use in this population.
Background:
Simvastatin, a 3-hydroxy 3-methylglutaryl co-enzyme A (HMG-CoA) reductase inhibitor, is used widely for treatment of hypercholesterolemia. Simvastatin may be a suitable treatment for dyslipidemia in hemodialysis (HD) patients. However, investigation of the side-effects and safety of long-term administration of simvastatin to HD patients has been limited. In this study, we investigated the effects and safety of simvastatin and its effects on lipoprotein metabolism in hypercholesterolemic patients on HD.
Methods:
Simvastatin was administered at a dosage of 5 mg/day for 24 weeks to 38 HD patients with high serum total cholesterol (TC) levels (200 mg/dl) or low high-density lipoprotein cholesterol (HDL-C) levels (35 mg/dl). Every four weeks, serum lipids, apolipoprotein, lipoprotein (a) [Lp(a)] and malondialdehyde (MDA) levels were measured. In addition, lipid levels were determined in each lipoprotein fraction separated by ultracentrifugation.
Results:
After 24 weeks of simvastatin administration, TC significantly decreased by 25.7%, and low-density lipoprotein cholesterol (LDL-C) was significantly decreased by 33.6%. Triglyceride (TG) and HDL-C showed no significant changes. Apolipoprotein (apo) B significantly decreased by 24.5% and apo E by 30.0%. No significant changes were observed in the other apolipoproteins. MDA was also significantly decreased, whereas Lp(a) was not significantly altered. In the lipoprotein fractions, very LDL cholesterol (VLDL-C), intermediate-density lipoprotein cholesterol (IDL-C), LDL1 cholesterol (LDL1-C), and LDL2 cholesterol (LDL2-C) showed significant decreases. No particular side-effects were observed during the 12 months of simvastatin administration.
Conclusions:
These results suggest that simvastatin appears to be safe and effective in HD patients with hypercholesterolemia.
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