Atorvastatin reduces microalbuminuria in patients with familial hypercholesterolemia and normal glucose tolerance

Anecdotal evidence indicates that significant lowering of LDL-cholesterol by means of LDL apheresis may reduce the level of microalbuminuria in heterozygous familial hypercholesterolemia. We therefore examined whether treatment with the most potent LDL-lowering drug available (atorvastatin) has a similar effect on the level of microalbuminuria.

In a case series, 100 patients with familial heterozygous hypercholesterolemia were started on 10 mg atorvastatin. 62 patients were switched to 40 mg atorvastatin once in the evening when the LDL-cholesterol treatment goals were not reached within 1 month.

Baseline serum creatinine clearance significantly improved after 1, 3 and 6 months, while serum urea and serum creatinine were unchanged. Blood pressure exhibited a lowering trend. After one month of treatment, the mean level of microalbuminuria was significantly improved in both dose regimens, showing further improvement after 3 months and stabilizing thereafter.

These data indicate that significant lowering of LDL-cholesterol with atorvastatin may favorably affect kidney function, in particular microalbuminuria as a measure of endothelial function. It remains to be seen whether this effect can be attributed to lipid lowering alone.