[Effect of pravastatin on hypercholesterolemia associated with proteinuria]

Hyperlipidemia associated to nephrotic syndrome has been involved in the deterioration of the renal function in these patients. The reduction in the synthesis of cholesterol with pravastatin, an hydrophilic inhibitor of such synthesis, may improve both the dyslipemia, the renal function and the proteinuria.

We conducted a controlled open randomized study in 16 patients with proteinuria greater than 2 g/day, creatinine clearance greater than 0.5 ml/s (30 ml/min) and hypercholesterolemia with LDL cholesterol greater than 4.9 mmol/l (190 mg/dl) distributed in two groups. One of these groups received hypolipemiant dietetic treatment and 20-40 mg of pravastatin and the other group, only the dietetic treatment.

The patients receiving pravastatin showed a 27% decrease in total plasmatic cholesterol, compared to a 6.7% in the control group (p < 0.01). This decrease was more evident in the LDL cholesterol fraction (44 vs 9%; p < 0.01). No significant modifications were observed in the HDL cholesterol fraction, triglycerides, renal function or proteinuria. Neither clinical nor enzymatiz adverse effects from hepatic or muscular origin were observed.