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Effects of statins on renal function
1Division of Nephrology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA. ragarwal@iupui.edu
The American Journal of Cardiology
|February 24, 2006
Summary
Statins (HMG-CoA reductase inhibitors) may slow kidney function decline in chronic kidney disease patients. Proteinuria incidence is low (1-2%) and may indicate beneficial effects on kidney cells.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Chronic kidney disease (CKD) patients often have dyslipidemia, increasing cardiovascular risk.
- Statins are used for dyslipidemia but concerns exist regarding statin-induced proteinuria.
- Subgroup analyses show cardiovascular benefits of statins in CKD patients.
Purpose of the Study:
- To review data on proteinuria development in CKD patients treated with statins.
- To assess the safety and efficacy of statins in renally impaired patients.
Main Methods:
- Review of experimental studies and post hoc analyses of clinical trials.
- Analysis of data on proteinuria development and renal function changes.
Main Results:
- Experimental studies suggest statin-induced proteinuria may result from inhibited endocytosis in proximal tubular cells.
- This inhibition may reduce inflammation, slow fibrosis, and diminish proteinuria long-term.
- Statins have shown potential to preserve glomerular filtration rate and reduce proteinuria in nondiabetic renal disease.
Conclusions:
- Collective evidence suggests statin therapy may slow renal function decline in atherosclerotic disease.
- Proteinuria incidence with potent statins is low (1-2%) at recommended doses.
- Ongoing trials will further examine statin safety and efficacy in renally compromised patients.