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Lipid and apoprotein changes during atorvastatin up-titration in hemodialysis patients with hypercholesterolemia: a

R L Lins1, K E Matthys, J M Billiouw

  • 1ZNA - Jan Palfijn, Merksem, Brussels, Belgium. robert.lins@village.uunet.be

Clinical Nephrology
|November 5, 2004
PubMed

Insights

Atorvastatin effectively improved lipid profiles in hemodialysis patients, reducing harmful lipoproteins and triglycerides. This suggests atorvastatin is a beneficial treatment for hypercholesterolemia in this high-risk group.

Area of Science:

  • Nephrology
  • Cardiovascular Medicine
  • Pharmacology

Background:

  • End-stage renal disease (ESRD) patients exhibit an atherogenic lipid profile, increasing cardiovascular risk.
  • This profile includes elevated remnant lipoproteins, small dense low-density lipoprotein (sdLDL), and low high-density lipoprotein (HDL).
  • Atorvastatin, a potent lipid regulator, may offer significant benefits in managing dyslipidemia in ESRD patients.

Purpose of the Study:

  • To evaluate the efficacy of atorvastatin in improving the lipid profile of hemodialysis patients.
  • To determine if atorvastatin can effectively lower lipid levels in this specific high-risk subgroup.

Main Methods:

  • A randomized, placebo-controlled, double-blind study was conducted.
  • 42 hypercholesterolemic hemodialysis patients received escalating doses of atorvastatin (10-40 mg daily) over 4 weeks.
  • Plasma lipids and apoproteins were measured in isolated lipoprotein fractions.

Main Results:

  • Atorvastatin significantly reduced total cholesterol (-33%) and low-density lipoprotein cholesterol (LDL-C) (-43%) after 12 weeks.
  • HDL-C levels remained unchanged, while triglycerides and apoprotein C-III were lowered with dose escalation.
  • Apoprotein B, apoprotein E, and sdLDL fractions were significantly reduced, with intermediate-density lipoproteins becoming undetectable.

Conclusions:

  • Atorvastatin effectively treated hypercholesterolemia and favorably altered the uremic lipid profile in hemodialysis patients.
  • Dose escalation of atorvastatin up to 40 mg daily was well-tolerated.
  • Further studies are required to assess the impact of these lipid improvements on patient morbidity and mortality.
Abstract

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