[The interest of statins in nephrology]

STATINS IN THE CASE OF CHRONIC RENAL DISEASE: Data of several large clinical trials in the general population demonstrated that hydroxymethyl glutaryl coenzyme A reductase inhibitors (statins) are effective in cardiovascular disease prevention with a relatively safe profile. Patients with chronic kidney disease (CKD) are at high risk for developing premature cardiovascular disease, so the benefits of statin therapy might be expected to be substantial in this population. Adjusted dose of statins to calcinurine inhibitors and renal function seem to exhibit a favorable risk/benefit ratio in CKD patients.

Statin use is CKD patients has been associated with a certain efficacy of cardiovascular disease prevention in several uncontrolled trials, and one randomized trial in renal transplant recipients. Several other large-scale randomized trials in CKD patients [4D (atorvastatin), AURORA (rosuvastatin) and SHARP (simvastatin/ezetimib) are currently underway. The results of these trials will permit evidence-based medicinal arguments justifying life-long clinical use of statins for cardiovascular prevention in CKD patients with progressive renal dysfunction, but data are inconclusive.

Clinically relevant plethoric effects associated with statin therapy in CKD patients might be restricted to the decrease of inflammation and oxidative stress.