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Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy--a meta-analysis of 11
Marcin Barylski1, Shekoufeh Nikfar, Dimitri P Mikhailidis
1Department of Internal Medicine and Cardiological Rehabilitation, Medical University of Lodz, Poland.
Pharmacological Research
|April 2, 2013
Summary
Statins significantly reduce mortality and cardiovascular events in chronic kidney disease (CKD) patients not on dialysis. However, benefits for dialysis patients are less clear, with statins only showing a reduction in cardiac events and mortality.
Area of Science:
- Nephrology
- Cardiology
- Pharmacology
Background:
- Previous studies indicated statin benefits for chronic kidney disease (CKD) patients.
- Conflicting results emerged regarding statin efficacy in end-stage renal disease (ESRD) patients undergoing dialysis.
Purpose of the Study:
- To conduct a meta-analysis evaluating statin therapy's impact on cardiovascular events and mortality in CKD patients.
- To provide reliable trial data on statin use across different stages of CKD.
Main Methods:
- A comprehensive literature search was conducted across PubMed, Web of Science, Cochrane Library, and Scopus (1966-October 2012).
- Included 11 randomized controlled trials (RCTs) with 21,295 CKD participants, including 6,857 on dialysis.
- Meta-analysis was performed to assess outcomes.
Main Results:
- In non-dialysis CKD patients, statins significantly reduced all-cause mortality (RR: 0.66), cardiac mortality (RR: 0.69), cardiovascular events (RR: 0.55), and stroke (RR: 0.66).
- In dialysis-dependent CKD patients, statins showed a non-significant effect on all-cause mortality (RR: 0.99) and stroke (RR: 1.31).
- Statins did reduce cardiac mortality (RR: 0.79) and cardiovascular events (RR: 0.81) in dialysis patients.
Conclusions:
- Statin therapy is recommended for cardiovascular disease prevention, particularly in non-dialysis-dependent CKD patients.
- Caution is advised regarding the expected reduction in cardiovascular events for dialysis patients due to limited data.
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