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The role of statins in chronic kidney disease

Rigas G Kalaitzidis1, Moses S Elisaf

  • 1Department of Internal Medicine, Medical School, University of Ioannina, Greece.

American Journal of Nephrology
|July 28, 2011
PubMed

Insights

Statins may benefit cardiovascular disease (CVD) prevention in chronic kidney disease (CKD) patients, especially those not on dialysis. Evidence for benefits in dialysis patients and on kidney function is still being clarified.

Area of Science:

  • Nephrology
  • Cardiology
  • Pharmacology

Background:

  • Cardiovascular disease (CVD) is a major cause of death in chronic kidney disease (CKD) patients.
  • Statins are widely used for CVD prevention in the general population.
  • The role of statins in primary CVD prevention for CKD patients requires further clarification.

Purpose of the Study:

  • To review the clinical evidence for statin use in CKD patients.
  • To examine the benefits of statins in primary CVD prevention in CKD.
  • To assess the impact of statins on proteinuria and renal disease progression.

Main Methods:

  • Review of clinical trials and studies on statin use in CKD patients.
  • Analysis of data regarding CVD events, proteinuria, and renal function.
  • Inclusion of findings from major trials like the Study of Heart and Renal Protection (SHARP).

Main Results:

  • Statins appear to offer greater absolute benefit for CVD prevention in non-dialysis CKD patients.
  • Studies in dialysis patients yielded mixed results, though SHARP suggests potential benefits with ezetimibe.
  • Effects of statins on proteinuria and renal disease progression are conflicting, with some studies showing reduction and others no effect or even increased proteinuria at high doses.

Conclusions:

  • Statins are a principal therapy for atherosclerosis and CVD prevention.
  • Further research is needed to clarify the role and optimal use of statins in CKD patients, particularly those on dialysis.
  • The impact of statins on renal outcomes in CKD remains an area of active investigation.

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