Statin therapy in peritoneal dialysis patients: effects beyond lipid lowering

Lipid abnormalities, and especially hypertriglyceridaemia, are a prominent feature of peritoneal dialysis (PD) patients. The results from several studies have shown that statins are effective and safe lipid-lowering agents in these individuals. Besides lipid lowering, current evidence suggests that these agents exert multiple beneficial effects on PD patients. Statins may maintain residual kidney function by altering the response of the kidneys to dyslipidaemia and, thus, slow the progression of renal failure in PD patients. Also, statins may reduce the incidence of cardiovascular events, as well as morbidity and mortality rates in this high-risk group. However, despite the multiple beneficial effects, PD patients receive suboptimal statin treatment. Apart from the German Dialysis and Diabetes (4D) study, no other prospective, randomised controlled trial has investigated the effects of statin treatment on dialysis patients. The results of large-scale, multi-centre randomised controlled studies (such as AURORA and SHARP) are expected to define the role of statin therapy in this high-risk population.