Statins can improve proteinuria and glomerular filtration rate loss in chronic kidney disease patients, further reducing cardiovascular risk. Fact or fiction?

Athyros, Vasilios G.; Katsiki, Niki; Karagiannis, Asterios; Mikhailidis, Dimitri P.

doi:10.1517/14656566.2015.1053464

Cited by 44 publications

(31 citation statements)

References 114 publications

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“…On the one hand, meta-analyses [14, 36] have shown that lowering LDL-C with statin therapy could effectively reduce vascular risk among patients with mild-to-moderate CKD and delay the progress of CKD. On the other hand, the pleiotropic effects of statins [37-39], which included reducing free radical levels, increasing endothelial nitric oxide synthase levels and inhibiting the activity of excitotoxic amino acids and the production of inflammatory mediators, could also decrease common risk factors of CKD and cerebrovascular diseases [40] (e.g., oxidative stress and inflammation).…”

Section: Discussionmentioning

confidence: 99%

Statin Use during Hospitalization and Short-Term Mortality in Acute Ischaemic Stroke with Chronic Kidney Disease

et al. 2018

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Objectives: Statin use during hospitalization improves prognosis in patients with ischaemic stroke. However, it remains uncertain whether acute ischaemic stroke patients with chronic kidney disease (CKD) benefit from statin therapy. We investigated the effect of statin use during hospitalization in reducing short-term mortality of patients with ischaemic stroke and CKD. Methods: Data of first-ever ischaemic stroke patients without a history of pre-stroke statin treatment was derived from the China National Stroke Registry. Patients were stratified according to estimated glomerular filtration rate (eGFR): normal renal function (eGFR ≥90 mL/min/1.73 m²), mild CKD (eGFR 60–90 mL/min/1.73 m²) and moderate CKD (eGFR < 60 mL/min/1.73 m²). Multivariate logistic regression analysis was used to evaluate the association between statin use during hospitalization and all-cause mortality with different renal functions at 3-month follow-up. Results: Among 5,951 patients included, 2,595 (43.6%) patients were on statin use during hospitalization after stroke (45.7% in patients with normal renal function, 42.0% in patients with mild CKD, and 39.0% in patients with moderate CKD). Compared with the non-statin group, statin use during hospitalization was associated with decreased all-cause mortality in patients with normal renal function (OR 0.65, 95% CI 0.43–0.97, p = 0.04), mild CKD (OR 0.59, 95% CI 0.38–0.91, p = 0.02) and moderate CKD (OR 0.41, 95% CI 0.23–0.75, p = 0.004) at 3-month follow-up. Conclusions: Statin use during hospitalization was associated with decreased 3-month mortality of ischaemic stroke patients with mild and moderate CKD. However, the conclusion should be confirmed in further studies with larger population, especially with moderate CKD.

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Section: Discussionmentioning

confidence: 99%

Statin Use during Hospitalization and Short-Term Mortality in Acute Ischaemic Stroke with Chronic Kidney Disease

et al. 2018

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“…It is clear that progress in proteinuria and permanent renal damage is corrected by early treatment of albuminuria patients (32) . There are numerous studies that examine the relationship between albuminuria and use of statin (30,(33)(34)(35) .…”

Section: Effects Of Statins In Chronic Renal Failurementioning

confidence: 99%

Beyond the Lipid-lowering Effects of Statins: Renal Effects

Kaya¹,

Kaya²,

Bekataş³

2017

Kosuyolu Heart Journal

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Nowadays statins, 3 hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase enzyme inhibitors, are used in the treatment of hyperlipidemia. Statins have been shown to decrease cardiovascular mortality and morbidity in both coronary artery disease and peripheral arterial disease. Besides their lipid-lowering effects, statins have pleiotropic effects such as improvement of endothelial dysfunction, atherosclerotic plaques stabilization, oxidative stress inhibition, anti-inflammatory, and antithrombogenic effects. Some clinical trials have revealed that statin therapy improved renal function. On the other hand, statins have been shown to have no beneficial effects in many studies in renal function. In this review, we aimed to evaluate the effects of statins on renal function.Key Words: Statin; chronic renal disease; acute renal disease; contrast-induced nephropathy Statinlerin Lipit Düşürücü Etkilerinin Ötesi: Renal Etkileri ÖZETStatin 3-hidroksi-3-metilglutaril CoA (HMG CoA) redüktaz enzim inhibitörü olarak günümüzde hiperlipidemi tedavisinde yaygın olarak kullanılmaktadır. Özellikle koroner arter hastalığı ve periferik arter hastalığında morbidite ve mortaliteyi azalttığı gösterilmiştir. Aynı zamanda aterosklerotik plak stabilizasyonu, endotel fonksiyonunu iyileştirme, oksidatif stres, inflamasyon ve tromboza yanıtın inhibisyonu gibi pleiotropik etkileri de bulunmaktadır. Statinin kanıtlanmış birçok yararlı etkisinin olmasının yanında, özellikle böbrek fonksiyonları üzerine etkisiyle ilgili çalışmalarda çelişkili sonuçlar bulunmaktadır. Bazı klinik çalışmalarda statinin böbrek fonksiyonları üzerine faydalı olduğu saptanmışken, birçok çalışmada da faydalı etkisinin olmadığı gösterilmiştir. Biz bu derlemede statin ile akut, kronik ve kontrasta bağlı nefropati ilişkilerini araştıran çalışmaları inceleyerek, statinin böbrek fonksiyonları üzerine etkisini değerlendirmeye çalıştık.

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“…For example, patients with sickle cell disease can develop oxidative stress and chronic inflammation to their distal vasculature as a result of transient vaso-occlusion and subsequent [196][197][198] Decrease decline in GFR Prevent contrast induced acute kidney injury Decrease risk of stroke Fracture injuries, bone healing, & osteoporosis [199][200][201][202][203][204] Promote mesenchymal cell differentiation to osteoblasts Protect osteoblasts from apoptosis Reduce osteoclast activity and bone resorption HIV [205][206][207][208][209][210][211] Slow progression of vascular disease on ART Improve flow-mediated vasodilation Implement immunomodulation Reduce all-cause mortality Immunomodulation [212][213][214] Inhibit interferon production Decrease T cell activation Infection [215][216][217][218] Reduce risk of mortality from bacterial and viral infection Lupus [219][220][221][222] Reduce C-reactive protein Reduce circulating chemokines Improve endothelial function Polycystic ovary syndrome [223][224][225] Reduce markers of inflammation Reduce androgenic steroid concentrations Rheumatoid arthritis [226][227][228][229][230][231] Reduce risk of mortality Reduce joint pain/swelling Reduce markers of inflammation Rotator cuff injury 232,233 Stimulate migration and adhesi...…”

Section: Future Considerationsmentioning

confidence: 99%

Pediatric Statin Administration: Navigating a Frontier with Limited Data

Wagner

Abdel‐Rahman

2016

The Journal of Pediatric Pharmacology and Therapeutics

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Increasingly, children and adolescents with dyslipidemia qualify for pharmacologic intervention. As they are for adults, 3-hydroxy-3-methyl-glutaryl-coenzyme A reductase inhibitors (statins) are the mainstay of pediatric dyslipidemia treatment when lifestyle modifications have failed. Despite the overall success of these drugs, the magnitude of variability in dose-exposure-response profiles contributes to adverse events and treatment failure. In children, the cause of treatment failures remains unclear. This review describes the updated guidelines for screening and management of pediatric dyslipidemia and statin disposition pathway to assist the provider in recognizing scenarios where alterations in dosage may be warranted to meet patients' specific needs.

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Statins can improve proteinuria and glomerular filtration rate loss in chronic kidney disease patients, further reducing cardiovascular risk. Fact or fiction?

Cited by 44 publications

References 114 publications

Statin Use during Hospitalization and Short-Term Mortality in Acute Ischaemic Stroke with Chronic Kidney Disease

Statin Use during Hospitalization and Short-Term Mortality in Acute Ischaemic Stroke with Chronic Kidney Disease

Beyond the Lipid-lowering Effects of Statins: Renal Effects

Pediatric Statin Administration: Navigating a Frontier with Limited Data

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