BACKGROUND: The effect of atorvastatin on kidney function was assessed in patients with stages 2-4 chronic kidney disease. METHODS: We conducted a randomised, double-blind, placebo-controlled trial in chronic kidney disease clinics in Northern Tasmania and enrolled 132 patients with serum creatinine levels >120 μmol/l, not taking lipid-lowering therapy and at all levels of proteinuria and serum cholesterol. Patients were randomly assigned to receive either 10 mg of atorvastatin/day (64) or placebo (68) and were followed with trial visits 3-monthly for a mean of 2.5 yrs. The primary outcome was the rate of both MDRD eGFR and Cockcroft-Gault creatinine clearance (C-G CrCl) decline. Analysis was based on intention to treat and included all patients that had at least one follow-up visit. RESULTS: The rate of MDRD eGFR decline was 29% lower; 1.04 ± 3.84 vs. 1.47 ± 3.74 ml/min/1.73 m(2)/yr (P=0.53), and the C-G CrCl was 20% lower; 1.88 ± 5.07 vs. 2.36 ± 4.61 ml/min/1.73 m(2)/yr (P=0.58) in atorvastatin-treated, compared with placebo-treated patients. Although blood pressure decreased in both atorvastatin and placebo-treated groups there were no differences between groups. In addition, there was no difference in concomitant medication intake including angiotensin converting enzyme inhibitors and angiotensin receptor blockers between groups. CONCLUSIONS: There was a trend toward a slower eGFR decline in the atorvastatin-treated group that did not reach statistical significance. This may have been due to the lack of power of the study. However, atorvastatin may have a renoprotective effect in those patients with chronic kidney disease and cardiovascular disease. This needs to be assessed in further studies.
RCT Entities:
BACKGROUND: The effect of atorvastatin on kidney function was assessed in patients with stages 2-4 chronic kidney disease. METHODS: We conducted a randomised, double-blind, placebo-controlled trial in chronic kidney disease clinics in Northern Tasmania and enrolled 132 patients with serum creatinine levels >120 μmol/l, not taking lipid-lowering therapy and at all levels of proteinuria and serum cholesterol. Patients were randomly assigned to receive either 10 mg of atorvastatin/day (64) or placebo (68) and were followed with trial visits 3-monthly for a mean of 2.5 yrs. The primary outcome was the rate of both MDRD eGFR and Cockcroft-Gault creatinine clearance (C-G CrCl) decline. Analysis was based on intention to treat and included all patients that had at least one follow-up visit. RESULTS: The rate of MDRD eGFR decline was 29% lower; 1.04 ± 3.84 vs. 1.47 ± 3.74 ml/min/1.73 m(2)/yr (P=0.53), and the C-G CrCl was 20% lower; 1.88 ± 5.07 vs. 2.36 ± 4.61 ml/min/1.73 m(2)/yr (P=0.58) in atorvastatin-treated, compared with placebo-treated patients. Although blood pressure decreased in both atorvastatin and placebo-treated groups there were no differences between groups. In addition, there was no difference in concomitant medication intake including angiotensin converting enzyme inhibitors and angiotensin receptor blockers between groups. CONCLUSIONS: There was a trend toward a slower eGFR decline in the atorvastatin-treated group that did not reach statistical significance. This may have been due to the lack of power of the study. However, atorvastatin may have a renoprotective effect in those patients with chronic kidney disease and cardiovascular disease. This needs to be assessed in further studies.
Authors: Marcello Tonelli; Anita Lloyd; Fiona Clement; Jon Conly; Don Husereau; Brenda Hemmelgarn; Scott Klarenbach; Finlay A McAlister; Natasha Wiebe; Braden Manns Journal: CMAJ Date: 2011-10-11 Impact factor: 8.262
Authors: Eugene J Barrett; Zhenqi Liu; Mogher Khamaisi; George L King; Ronald Klein; Barbara E K Klein; Timothy M Hughes; Suzanne Craft; Barry I Freedman; Donald W Bowden; Aaron I Vinik; Carolina M Casellini Journal: J Clin Endocrinol Metab Date: 2017-12-01 Impact factor: 5.958
Authors: Suetonia C Palmer; Jonathan C Craig; Sankar D Navaneethan; Marcello Tonelli; Fabio Pellegrini; Giovanni F M Strippoli Journal: Ann Intern Med Date: 2012-08-21 Impact factor: 25.391
Authors: Kazem Rahimi; Neeraj Bhala; Pieter Kamphuisen; Jonathan Emberson; Sara Biere-Rafi; Vera Krane; Michele Robertson; John Wikstrand; John McMurray Journal: PLoS Med Date: 2012-09-18 Impact factor: 11.069