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Relationship of High-Density Lipoprotein Cholesterol With Renal Function in Patients Treated With Atorvastatin

Kwok Leung Ong1, David D Waters2, Rana Fayyad3

  • 1School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia kwokleung.ong@unsw.edu.au.

Journal of the American Heart Association
|January 24, 2018
PubMed

Insights

In patients taking atorvastatin, higher high-density lipoprotein (HDL) cholesterol levels protected against kidney function decline in those with normal baseline kidney function. Further research is needed to confirm a causal link between HDL and renal health.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • The relationship between high-density lipoprotein (HDL) cholesterol and renal function in patients receiving statins is not well understood.
  • Investigating this association is crucial for understanding cardiovascular and renal health outcomes in statin-treated populations.

Purpose of the Study:

  • To determine if HDL cholesterol levels predict renal function in patients treated with atorvastatin.
  • To analyze the impact of HDL cholesterol on estimated glomerular filtration rate (eGFR) decline within the Treating to New Targets (TNT) trial.

Main Methods:

  • Analysis of 9542 participants from the TNT trial.
  • Assessment of renal function using estimated glomerular filtration rate (eGFR).
  • Measurement of HDL cholesterol levels at month 3, when they stabilize during atorvastatin treatment.

Main Results:

  • In patients with normal baseline eGFR (≥60 mL/min per 1.73 m²), higher HDL cholesterol levels at month 3 were significantly associated with a lower risk of eGFR decline.
  • For participants with normal baseline eGFR, increasing HDL cholesterol quintiles showed a trend towards reduced risk of renal function decline (P for trend=0.006).
  • In patients with impaired baseline eGFR (<60 mL/min per 1.73 m²), HDL cholesterol levels had a less pronounced impact on eGFR during follow-up, with significance only observed when analyzed continuously (P=0.043).

Conclusions:

  • Higher HDL cholesterol levels are linked to a reduced risk of kidney function decline in atorvastatin-treated patients with normal baseline renal function.
  • The study suggests a protective role of HDL cholesterol in maintaining renal function in this cohort.
  • Further investigation is required to establish a causal relationship between HDL cholesterol and renal function preservation.
Abstract

Keywords:
atorvastatinepidemiologyestimated glomerular filtration ratehigh‐density lipoprotein cholesterolkidneyrenal function

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