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Meta-analysis: the effect of statins on albuminuria.
Ann Intern Med. 2006 Jul 18; 145(2):117-24.AIM

Abstract

BACKGROUND

Albuminuria is an independent risk factor for cardiovascular and renal disease with limited therapeutic options. Data on the effects of statins on albuminuria are conflicting.

PURPOSE

To determine whether and to what degree statins affect albuminuria.

DATA SOURCES

English-language and non-English-language studies found in PubMed, MEDLINE, EMBASE, BIOSIS, SciSearch, PASCAL, and International Pharmaceutical Abstracts (IPA) databases and the Cochrane Central Register of Controlled Trials that were published between January 1974 and November 2005.

STUDY SELECTION

Randomized, placebo-controlled trials of statins reporting baseline and follow-up measurements of albuminuria or proteinuria measured by 24-hour urine collection or the urinary albumin-to-creatinine ratio.

DATA EXTRACTION

Two investigators independently abstracted study quality, characteristics, and outcomes.

DATA SYNTHESIS

Fifteen studies involving a total of 1384 patients and averaging 24 weeks in duration were included. Meta-analysis of the proportional reduction in proteinuria showed that statins reduced albuminuria (11 studies) and proteinuria (4 studies) in 13 of 15 studies. The reduction in excretion was greater among studies with greater baseline albuminuria or proteinuria: change of 2% (95% CI, -32% to 35%) for those with excretion less than 30 mg/d, -48% (CI, -71% to -25%) for those with excretion of 30 to 300 mg/d, and -47% (CI, -67% to -26%) for those with excretion more than 300 mg/d. Statistical heterogeneity was evident only in the group with excretion greater than 300 mg/d (excretion < 30 mg/d, I2 = 23% [P = 0.27]; excretion of 30 to 299 mg/d, I2 = 0% [P = 0.64]; excretion > or = 300 mg/d, I2 = 63% [P = 0.020]).

LIMITATIONS

Published studies were not of high quality on average and varied markedly in effect size, as well as in characteristics of the cohorts. Unpublished studies showing no effect could impact these results.

CONCLUSION

Statins may have a beneficial effect on pathologic albuminuria. The validity of this finding, and whether this effect translates into reduction of cardiovascular or end-stage renal disease, requires larger studies.

Authors+Show Affiliations

Walter Reed Army Medical Center, Washington, DC 20307, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review

Language

eng

PubMed ID

16847294

Citation

Douglas, Kevin, et al. "Meta-analysis: the Effect of Statins On Albuminuria." Annals of Internal Medicine, vol. 145, no. 2, 2006, pp. 117-24.
Douglas K, O'Malley PG, Jackson JL. Meta-analysis: the effect of statins on albuminuria. Ann Intern Med. 2006;145(2):117-24.
Douglas, K., O'Malley, P. G., & Jackson, J. L. (2006). Meta-analysis: the effect of statins on albuminuria. Annals of Internal Medicine, 145(2), 117-24.
Douglas K, O'Malley PG, Jackson JL. Meta-analysis: the Effect of Statins On Albuminuria. Ann Intern Med. 2006 Jul 18;145(2):117-24. PubMed PMID: 16847294.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meta-analysis: the effect of statins on albuminuria. AU - Douglas,Kevin, AU - O'Malley,Patrick G, AU - Jackson,Jeffrey L, PY - 2006/7/19/pubmed PY - 2006/8/5/medline PY - 2006/7/19/entrez SP - 117 EP - 24 JF - Annals of internal medicine JO - Ann Intern Med VL - 145 IS - 2 N2 - BACKGROUND: Albuminuria is an independent risk factor for cardiovascular and renal disease with limited therapeutic options. Data on the effects of statins on albuminuria are conflicting. PURPOSE: To determine whether and to what degree statins affect albuminuria. DATA SOURCES: English-language and non-English-language studies found in PubMed, MEDLINE, EMBASE, BIOSIS, SciSearch, PASCAL, and International Pharmaceutical Abstracts (IPA) databases and the Cochrane Central Register of Controlled Trials that were published between January 1974 and November 2005. STUDY SELECTION: Randomized, placebo-controlled trials of statins reporting baseline and follow-up measurements of albuminuria or proteinuria measured by 24-hour urine collection or the urinary albumin-to-creatinine ratio. DATA EXTRACTION: Two investigators independently abstracted study quality, characteristics, and outcomes. DATA SYNTHESIS: Fifteen studies involving a total of 1384 patients and averaging 24 weeks in duration were included. Meta-analysis of the proportional reduction in proteinuria showed that statins reduced albuminuria (11 studies) and proteinuria (4 studies) in 13 of 15 studies. The reduction in excretion was greater among studies with greater baseline albuminuria or proteinuria: change of 2% (95% CI, -32% to 35%) for those with excretion less than 30 mg/d, -48% (CI, -71% to -25%) for those with excretion of 30 to 300 mg/d, and -47% (CI, -67% to -26%) for those with excretion more than 300 mg/d. Statistical heterogeneity was evident only in the group with excretion greater than 300 mg/d (excretion < 30 mg/d, I2 = 23% [P = 0.27]; excretion of 30 to 299 mg/d, I2 = 0% [P = 0.64]; excretion > or = 300 mg/d, I2 = 63% [P = 0.020]). LIMITATIONS: Published studies were not of high quality on average and varied markedly in effect size, as well as in characteristics of the cohorts. Unpublished studies showing no effect could impact these results. CONCLUSION: Statins may have a beneficial effect on pathologic albuminuria. The validity of this finding, and whether this effect translates into reduction of cardiovascular or end-stage renal disease, requires larger studies. SN - 1539-3704 UR - https://www.unboundmedicine.com/medline/citation/16847294/Meta_analysis:_the_effect_of_statins_on_albuminuria_ L2 - https://www.acpjournals.org/doi/10.7326/0003-4819-145-2-200607180-00009?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -