Effect of statins on chronic inflammation and nutrition status in renal dialysis patients: A systematic review and meta‐analysis

Abstract

: Aim: 3‐hydroxy‐3‐methylglutaryl coenzyme A (HMG‐CoA) reductase inhibitors (statins) may have an adjunctive effect on chronic inflammation and nutrition status in renal dialysis patients. Therefore, we performed a systematic review of randomized controlled trials to assess the effect of statins on chronic inflammation and nutrition status in dialysis patients. Methods: The randomized controlled trials (RCTs) of statins versus placebo or no treatment for renal dialysis patients were searched from PubMed, EMbase and Cochran Central Register of Controlled Trials. We screened relevant studies according to predefined inclusion and exclusion criteria, evaluated the quality of the included studies, and performed meta‐analyses by using the Cochrane Collaboration's Revman 5.1 software. Results: We identified nine trials including 3098 patients. Meta‐analysis showed statins can significantly decrease the serum C‐reactive protein (CRP) (SMD, −0.54; 95% confidence interval (CI), −1.04 to −0.05; P = 0.03) and high sensitivity CRP (hs‐CRP) level (SMD, −0.72; 95% CI, −1.14 to −0.31; P = 0.0007) of dialysis patients compared with that of the control group. However, statins did not differ significantly from the control group in increasing the serum Alb level (SMD, −0.13; 95% CI, −0.42 to 0.15; P = 0.37). Conclusions: Statins can improve the chronic inflammation status reflected by the decreasing of serum CRP and hs‐CRP levels, whereas there is no conclusive evidence that it can improve the nutrition status. However, this result needs to be further confirmed in more high‐quality randomized clinical trials.

Association between albumin and C‐reactive protein and ankle‐brachial index in haemodialysis

“…Statin can attenuate VCAM‐1 expression in endothelial cell and reduce oxLDL levels . Furthermore, a meta‐analysis showed that statin decrease serum CRP levels significantly and can improve inflammatory status in dialysis patients . Thus, statin might play a pivotal role of pharmaceutical therapy for complex of malnutrition‐inflammation and PAOD in patients with ESRD.…”

Therapeutics targeting persistent inflammation in chronic kidney disease

“…According to a systematic review, statins may reduce CRP levels in dialysis patients, whereas there was no conclusive evidence that they may improve nutritional status. 73 However, in a post hoc analysis of the 4D study found among 1255 HD patients with type 2 diabetes, there were no significant changes in CRP related to atorvastatin treatment. 74 In a smaller RCT crossover study with 76 PD patients receiving either pravastatin or placebo for 2 months followed by a 1 month wash-out period and crossed over to another group for another 2 months period, pravastatin significantly reduced serum CRP and HDL-cholesterol levels compared with placebo.…”

Update on Inflammation in Chronic Kidney Disease

“…A number of recent studies were aimed at identifying the potential effects of these drugs on inflammation in CKD. Thus, a meta-analysis demonstrated that statins can improve chronic inflammatory status in dialysis patients [85]. Angiotensin II blockade in stages 3 and 4 CKD with olmesartan for 16 weeks resulted in a significant reduction of CRP and fibrinogen but no differences in adipokine levels [86].…”