Lipid abnormalities in the nephrotic syndrome: the therapeutic role of statins.

Hyperlipidaemia complicating the nephrotic syndrome is characterised by elevated levels of total and LDL cholesterol, often with hypertriglyceridaemia and low HDL cholesterol levels. The underlying mechanisms are complex but involve abnormalities of both lipoprotein synthesis and catabolism. Experience to date suggests that 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors or "statins" offer the most effective therapy and are relatively safe, at least in short term studies. The benefits of treatment remain unproven but may include a reduction in cardiovascular risk and preservation of residual renal function. Newly defined actions of statins, some of which may be unrelated to lipid lowering, are likely to extend the application of these drugs in patients with glomerular disease.