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A randomized trial of the effect of statin and fibrate therapy on arterial function in CKD

Gursharan Dogra1, Ashley Irish, Dick Chan

  • 1School of Medicine and Pharmacology, University of Western Australia and Western Australian Heart Research Institute, Perth, Western Australia. sdogra@meddent.uwa.edu.au

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
|May 30, 2007
PubMed

Insights

In advanced chronic kidney disease (CKD), atorvastatin improved dyslipidemia and arterial stiffness, but not endothelial function. Gemfibrozil improved dyslipidemia but did not affect arterial function in CKD patients.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Patients with chronic kidney disease (CKD) face elevated cardiovascular disease (CVD) risk.
  • The efficacy of lipid-modifying therapies in mitigating CVD risk in CKD patients remains unclear.
  • This study investigates statin and fibrate effects on arterial function, a key CVD risk marker.

Purpose of the Study:

  • To compare the effects of atorvastatin (statin) and gemfibrozil (fibrate) on arterial function in patients with advanced CKD.
  • To assess changes in lipid profiles, arterial compliance, and endothelial function.

Main Methods:

  • A double-blind, randomized, placebo-controlled, parallel-group study.
  • Participants included ambulatory patients with stages 3 to 5 CKD.
  • Interventions involved 6 weeks of atorvastatin (40 mg/d), gemfibrozil (600 mg twice daily), or placebo.

Main Results:

  • Atorvastatin significantly reduced LDL, triglycerides, and oxidized LDL. Gemfibrozil reduced triglycerides and increased HDL.
  • Neither drug significantly altered markers of insulin resistance or inflammation.
  • Atorvastatin improved small-artery compliance (C2), but neither drug affected endothelial-dependent (FMD) or independent (GTNMD) dilatation, or large-artery compliance (C1).

Conclusions:

  • Atorvastatin demonstrated benefits in dyslipidemia and arterial stiffness in advanced CKD patients.
  • Gemfibrozil improved dyslipidemia but did not impact arterial function.
  • Limitations include small sample size, short treatment duration, and patient heterogeneity.
Abstract

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