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Transient Proteinuria Induced by High-Dose Rosuvastatin
Khushi Goyal1, Sandeep S Soman2, Arti Bhan3
1Dayanand Medical College & Hospital, Ludhiana, Punjab, India.
AACE Endocrinology and Diabetes
|August 11, 2025
Summary
High-dose rosuvastatin can cause transient proteinuria, a reversible side effect. Switching to atorvastatin resolved the proteinuria, highlighting the need for individualized statin therapy and monitoring.
Area of Science:
- Cardiology
- Nephrology
- Pharmacology
Background:
- A 70-year-old woman with multiple comorbidities including diabetes, hypertension, and hyperlipidemia presented with non-ST elevation myocardial infarction.
- She was initiated on high-dose rosuvastatin therapy for hyperlipidemia management.
Observation:
- Following three months of high-dose rosuvastatin, the patient developed significant proteinuria (albumin-to-creatinine ratio of 344.1) and muscle cramps.
- Renal function remained stable, with a glomerular filtration rate above 70 mL/min/1.73 m².
- Pre-treatment urine albumin-to-creatinine ratios were within normal limits (<30 mg/g).
Findings:
- High-dose rosuvastatin therapy was associated with the development of transient, dose-dependent proteinuria.
- Proteinuria resolved after discontinuing rosuvastatin and switching to a combination of atorvastatin and ezetimibe.
- Lipid levels were effectively managed with the alternative medication regimen.
Implications:
- This case underscores the importance of monitoring for proteinuria as a potential side effect of high-dose statin therapy, particularly rosuvastatin.
- Individualized treatment approaches and careful dose titration are crucial for optimizing statin efficacy and patient safety.
- Prompt recognition and management of statin-induced proteinuria can prevent potential renal complications and improve patient adherence to lipid-lowering therapy.
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