HMG-CoA Reductase Inhibitors in Chronic Kidney Disease

Abstract

The incidence of chronic kidney disease (CKD) is on the rise in the USA. Cardiovascular events are the leading cause of death in this patient population, therefore reducing the risk of these events has become a major focus. The aim of this review is to assess current literature on the use of statins in CKD and end-stage renal disease. Cholesterol reduction is important in preventing the development and progression of coronary heart disease and its negative effects. Statins have been widely studied and proven to reduce cardiovascular risk in the general population. The information gained from trials has been extrapolated to special populations, including CKD, despite these patients often being excluded. However, recent studies have begun to focus on CKD, hemodialysis, and transplant patients and the use of cholesterol-lowering agents and the potential association with decreased cardiovascular events. In addition, due to the unique pharmacokinetic and pharmacodynamic changes that occur in these patients, choosing the appropriate cholesterol-lowering agent becomes important for both safety and efficacy. The complexity of CKD patients is an important consideration when choosing cholesterol-lowering medication. Patients with CKD are often on medications that may interact with many of the cholesterol-lowering agents. Ensuring drug interactions are minimized is essential to the prevention of adverse events from the medications.

Serelaxin improves cardiac and renal function in DOCA-salt hypertensive rats

“…5e ). Serelaxin also decreased the transcript levels of SREBP-2 and HMGCoAR, which are master regulators of cholesterol synthesis 31 , 32 , and decreased LDL receptor (Fig. 5f,g,h ), which is a mediator of cholesterol uptake and increased ABCA1 that mediates cholesterol efflux (Fig.…”

Cardiovascular Calcification Heterogeneity in Chronic Kidney Disease

“…Increasing evidence suggests that cardiovascular calcification is an independent risk factor for cardiovascular morbidity and mortality in the general population 21 and patients with CKD. 22 Traditional strategies to reduce this risk are largely ineffective in patients with CKD, 23 underscoring the importance of nontraditional CKD-specific cardiovascular risk factors that are hitherto unknown. Atherosclerotic end points like stroke or myocardial infarction are the leading cause of death in the general population.…”