Jacek Rysz1, Anna Gluba-Brzózka, Maciej Banach, Andrzej Więcek. 1. Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital of Lodz, Zeromskiego 113, 90-549, Lodz, Poland, jacek.rysz@umed.lodz.pl.
Abstract
PURPOSE: The aim of this article was to present the most important matters associated with dyslipidemia treatment in CKD patients. Moreover, the most important recommendations of the current (2013) KDIGO clinical practice guideline for lipid management in chronic kidney disease are presented. METHODS: Authors looked through the most recent large clinical trials and meta-analyses and presented their results. We searched using the electronic databases [MEDLINE, EMBASE, Scopus, DARE]. Additionally, abstracts from national and international cardiovascular meetings were studied. RESULTS: Analysis results suggest that statins exert beneficial effects on kidney since they considerably reduce 24 h urinary protein excretion and are associated with a rise in GFR. Beneficial effects of statins may be influenced by kidney disease stage, doses of medicine and treatment duration. Data suggest that statins are effective and safe for secondary prevention of CV events in individuals with mild CKD. Patients treated with statins had decreased frequency of major atherosclerotic events compared with placebo, reduced risk of CV mortality and deaths from all causes. CONCLUSIONS: Meta-analyses results suggest that statins are associated with lipid lowering, cardiovascular and anti-proteinuric benefits in CKD patients. However, their effects on overall and cardiovascular mortality are much less obvious. Bearing in mind the advantageous effects and low risk of adverse effects, it seems that mild renal impairment should not exclude these patients from receiving a statin. However, because CKD patients in stages III-V are underrepresented in clinical trials, administration of statins to these patients who have not yet had a vascular event remains controversial.
PURPOSE: The aim of this article was to present the most important matters associated with dyslipidemia treatment in CKDpatients. Moreover, the most important recommendations of the current (2013) KDIGO clinical practice guideline for lipid management in chronic kidney disease are presented. METHODS: Authors looked through the most recent large clinical trials and meta-analyses and presented their results. We searched using the electronic databases [MEDLINE, EMBASE, Scopus, DARE]. Additionally, abstracts from national and international cardiovascular meetings were studied. RESULTS: Analysis results suggest that statins exert beneficial effects on kidney since they considerably reduce 24 h urinary protein excretion and are associated with a rise in GFR. Beneficial effects of statins may be influenced by kidney disease stage, doses of medicine and treatment duration. Data suggest that statins are effective and safe for secondary prevention of CV events in individuals with mild CKD. Patients treated with statins had decreased frequency of major atherosclerotic events compared with placebo, reduced risk of CV mortality and deaths from all causes. CONCLUSIONS: Meta-analyses results suggest that statins are associated with lipid lowering, cardiovascular and anti-proteinuric benefits in CKDpatients. However, their effects on overall and cardiovascular mortality are much less obvious. Bearing in mind the advantageous effects and low risk of adverse effects, it seems that mild renal impairment should not exclude these patients from receiving a statin. However, because CKDpatients in stages III-V are underrepresented in clinical trials, administration of statins to these patients who have not yet had a vascular event remains controversial.
Authors: Folkert W Asselbergs; Gilles F H Diercks; Hans L Hillege; Ad J van Boven; Wilbert M T Janssen; Adriaan A Voors; Dick de Zeeuw; Paul E de Jong; Dirk J van Veldhuisen; Wiek H van Gilst Journal: Circulation Date: 2004-10-18 Impact factor: 29.690
Authors: Helen M Colhoun; D John Betteridge; Paul N Durrington; Graham A Hitman; H Andrew W Neil; Shona J Livingstone; Valentine Charlton-Menys; David A DeMicco; John H Fuller Journal: Am J Kidney Dis Date: 2009-06-21 Impact factor: 8.860
Authors: Maciej Banach; Piotr Jankowski; Jacek Jóźwiak; Barbara Cybulska; Adam Windak; Tomasz Guzik; Artur Mamcarz; Marlena Broncel; Tomasz Tomasik; Jacek Rysz; Agnieszka Jankowska-Zduńczyk; Piotr Hoffman; Agnieszka Mastalerz-Migas Journal: Arch Med Sci Date: 2016-12-19 Impact factor: 3.318