HMG CoA reductase inhibitors (statins) for dialysis patients

Navaneethan, Sd; Nigwekar, Su; Perkovic, Vlado; Johnson, David W.; Craig, Jonathan C.; Strippoli, Giovanni F.M.

doi:10.1002/14651858.cd004289.pub4

Cited by 17 publications

(15 citation statements)

References 48 publications

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“…Although pleiotrophic effects of statins are generally considered to represent a class effect [15], most studies have shown a protective effect of statins in ischemia-reperfusion injury with simvastastin [16-18,21], whilst only one study used atorvastatin [40]. A previously published systematic review by our group of 5 randomised controlled trials found no significant effect of statin use on the risk of acute rejection in renal transplant recipients (relative risk 0.61, 95% CI 0.32-1.16) [41]. Data were not available to evaluate the effect of statins on DGF.…”

Section: Discussionmentioning

confidence: 99%

Association of pre-transplant statin use with delayed graft function in kidney transplant recipients

et al. 2012

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BackgroundAdministration of HMG-CoA reductase inhibitors (statins), prior to ischemia or prior to reperfusion has been shown to decrease ischemia-reperfusion renal injury in animal studies. It is unknown whether this protective effect is applicable to renal transplantation in humans. The aim of this study was to determine the relationship between prior statin use in renal transplant recipients and the subsequent risk of delayed graft function.MethodsAll patients who underwent deceased or living donor renal transplantation at the Princess Alexandra Hospital between 1 July 2008 and 1 August 2010 were included in this retrospective, observational cohort study. Graft function was classified as immediate graft function (IGF), dialysis-requiring (D-DGF) and non-dialysis-requiring (ND-DGF) delayed graft function. The independent predictors of graft function were evaluated by multivariable logistic regression, adjusting for donor characteristics, recipient characteristics, HLA mismatch and ischaemic times.ResultsOverall, of the 266 renal transplant recipients, 21% exhibited D-DGF, 39% had ND-DGF and 40% had IGF. Statin use prior to renal transplantation was not significantly associated with the risk of D-DGF (adjusted odds ratio [OR] 1.05, 95% CI 0.96 – 1.15, P = 0.28). This finding was not altered when D-DGF and ND-DGF were pooled together (OR 0.98; 95% CI 0.89-1.06, p = 0.56).ConclusionsThe present study did not show a significant, independent association between prior statin use in kidney transplant recipients and the occurrence of delayed graft function.

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Section: Discussionmentioning

confidence: 99%

Association of pre-transplant statin use with delayed graft function in kidney transplant recipients

et al. 2012

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“…Therefore, the median value of the plasma S100A12 levels in the development population was used to dichotomize the data. Possible cutoff points for the other continuous variables for each laboratory test were determined according to their clinical importance using the results of previous studies and reference values [18-24]. The predictive value of the plasma S100A12 levels for two-year survival was estimated by the Kaplan–Meier analysis and evaluated using the log-rank test.…”

Section: Methodsmentioning

confidence: 99%

Prognostic utility of plasma S100A12 levels to establish a novel scoring system for predicting mortality in maintenance hemodialysis patients: a two-year prospective observational study in Japan

Shiotsu

Mori

Nishimura³

et al. 2013

BMC Nephrol

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BackgroundS100A12 protein is an endogenous receptor ligand for advanced glycation end products. In this study, the plasma S100A12 level was assessed as an independent predictor of mortality, and its utility in clinical settings was examined.MethodsIn a previous cross-sectional study, plasma S100A12 levels were measured in 550 maintenance hemodialysis patients to determine the association between S100A12 and the prevalence of cardiovascular diseases (CVD). In this prospective study, the risk of mortality within a two-year period was determined. An integer scoring system was developed to predict mortality on the basis of the plasma S100A12 levels.ResultsHigher plasma S100A12 levels (≥18.79 ng/mL) were more closely associated with higher all-cause mortality than lower plasma S100A12 levels (<18.79 ng/mL; P = 0.001). Multivariate Cox proportional hazards analysis revealed higher plasma S100A12 levels [hazard ratio (HR), 2.267; 95% confidence interval (CI), 1.195–4.302; P = 0.012], age ≥65 years (HR, 1.961; 95%CI, 1.017–3.781; P = 0.044), serum albumin levels <3.5 g/dL (HR, 2.198; 95%CI, 1.218–3.968; P = 0.012), and history of CVD (HR, 2.068; 95%CI, 1.146–3.732; P = 0.016) to be independent predictors of two-year all-cause mortality. The integer score was derived by assigning points to these factors and determining total scores. The scoring system revealed trends across increasing scores for predicting the all-cause mortality [c-statistic = 0.730 (0.656–0.804)]. The resulting model demonstrated good discriminative power for distinguishing the validation population of 303 hemodialysis patients [c-statistic = 0.721 (0.627–0.815)].ConclusionThe results indicate that plasma S100A12 level is an independent predictor for two-year all-cause mortality. A simple integer scoring system was therefore established for predicting mortality on the basis of plasma S100A12 levels.

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“…A Cochrane review, published in 2004, concluded that statins decreased serum cholesterol in dialysis patients as effectively as in the general population, but no conclusions were made about the effects of statins on cardiovascular mortality [57] .…”

Section: Therapeutic Measuresmentioning

confidence: 99%

Alterations of Lipid Metabolism in Chronic Nephropathies: Mechanisms, Diagnosis and Treatment

Lacquaniti

Bolignano

Donato

et al. 2010

Kidney Blood Press Res

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Nephropathic subjects show an increased tendency to develop cardiovascular diseases, mainly as the consequence of several risk factors including increased oxidative stress, inflammation, physical inactivity, anemia, vascular calcification, and endothelial dysfunction. The alterations in lipid metabolism represent a relatively lesser important cause of genesis and progression of atherosclerosis. Unfortunately, in these patients the atherogenic potential of dyslipidemia may depend more on apolipoproteins than on lipid abnormalities, and may not always be recognized by measurement of plasma lipids alone. The aim of this review was therefore to analyze the main lipid alterations that can occur in nephropathic patients, as well as their causes and their effects on the cardiovascular system. The clinical evidence and recommendations for the use of lipid-regulating drugs in patients with chronic kidney disease, nephrotic syndrome, in patients undergoing hemo- and peritoneal dialysis and in transplanted patients was also reviewed. Moreover, we analyzed the link between dyslipidemia and kidney disease onset and progression and the role of statins in preventing it.

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HMG CoA reductase inhibitors (statins) for dialysis patients

Cited by 17 publications

References 48 publications

Association of pre-transplant statin use with delayed graft function in kidney transplant recipients

Association of pre-transplant statin use with delayed graft function in kidney transplant recipients

Prognostic utility of plasma S100A12 levels to establish a novel scoring system for predicting mortality in maintenance hemodialysis patients: a two-year prospective observational study in Japan

Alterations of Lipid Metabolism in Chronic Nephropathies: Mechanisms, Diagnosis and Treatment

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