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Statin treatment for dyslipidemia in chronic kidney disease and renal transplantation: a review of the evidence.
J Nephrol. 2009 Sep-Oct; 22(5):598-609.JN

Abstract

Patients with chronic kidney disease (CKD) have significantly increased risks of cardiovascular (CV) morbidity and mortality. Dyslipidemia is a common disorder in CKD patients. CKD patients have a different lipid profile with increased atherogenic lipid fractions, and serum low-density lipoprotein cholesterol (LDL-C) levels may underestimate the atherogenic effect of LDL-C in these patients. Dyslipidemia may contribute to the increased CV morbidity and mortality, and to the progression of kidney disease in CKD patients. Currently, statins are the pharmacologic intervention of first choice, if lifestyle changes fail adequately to lower LDL-C levels in the setting of normal or moderately elevated triglycerides. Statins have been extensively studied in a large variety of patient populations and have proven efficacy in the treatment of dyslipidemia, and in reducing CV mortality. Although much evidence supports the CV benefits of statins in patients with normal renal function, there are contradictory results for the beneficial effect of statin therapy on CV morbidity and mortality in CKD patients. While post hoc subgroup analyses of multiple randomized trials support statin use in early CKD patients, the only randomized trial conducted in diabetic dialysis patients found no evidence of benefit in overall mortality. Post transplant there is some definite CV benefit, albeit in a patient cohort selected to be at reduced CV risk by virtue of being eligible for organ transplant. The results from the AURORA and SHARP studies are awaited anxiously.

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Authors+Show Affiliations

Kanbay M
Department of Internal Medicine, Section of Nephrology, Fatih University School of Medicine, Ankara, Turkey. mkanbay@yahoo.com
Turgut F
No affiliation info available
Covic A
No affiliation info available
Goldsmith D
No affiliation info available

MeSH

Cardiovascular DiseasesChronic DiseaseDyslipidemiasHumansHydroxymethylglutaryl-CoA Reductase InhibitorsKidney DiseasesKidney Failure, ChronicKidney Transplantation

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

19809992

Citation

Kanbay, Mehmet, et al. "Statin Treatment for Dyslipidemia in Chronic Kidney Disease and Renal Transplantation: a Review of the Evidence." Journal of Nephrology, vol. 22, no. 5, 2009, pp. 598-609.
Kanbay M, Turgut F, Covic A, et al. Statin treatment for dyslipidemia in chronic kidney disease and renal transplantation: a review of the evidence. J Nephrol. 2009;22(5):598-609.
Kanbay, M., Turgut, F., Covic, A., & Goldsmith, D. (2009). Statin treatment for dyslipidemia in chronic kidney disease and renal transplantation: a review of the evidence. Journal of Nephrology, 22(5), 598-609.
Kanbay M, et al. Statin Treatment for Dyslipidemia in Chronic Kidney Disease and Renal Transplantation: a Review of the Evidence. J Nephrol. 2009 Sep-Oct;22(5):598-609. PubMed PMID: 19809992.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statin treatment for dyslipidemia in chronic kidney disease and renal transplantation: a review of the evidence. AU - Kanbay,Mehmet, AU - Turgut,Faruk, AU - Covic,Adrian, AU - Goldsmith,David, PY - 2009/10/8/entrez PY - 2009/10/8/pubmed PY - 2009/12/16/medline SP - 598 EP - 609 JF - Journal of nephrology JO - J Nephrol VL - 22 IS - 5 N2 - Patients with chronic kidney disease (CKD) have significantly increased risks of cardiovascular (CV) morbidity and mortality. Dyslipidemia is a common disorder in CKD patients. CKD patients have a different lipid profile with increased atherogenic lipid fractions, and serum low-density lipoprotein cholesterol (LDL-C) levels may underestimate the atherogenic effect of LDL-C in these patients. Dyslipidemia may contribute to the increased CV morbidity and mortality, and to the progression of kidney disease in CKD patients. Currently, statins are the pharmacologic intervention of first choice, if lifestyle changes fail adequately to lower LDL-C levels in the setting of normal or moderately elevated triglycerides. Statins have been extensively studied in a large variety of patient populations and have proven efficacy in the treatment of dyslipidemia, and in reducing CV mortality. Although much evidence supports the CV benefits of statins in patients with normal renal function, there are contradictory results for the beneficial effect of statin therapy on CV morbidity and mortality in CKD patients. While post hoc subgroup analyses of multiple randomized trials support statin use in early CKD patients, the only randomized trial conducted in diabetic dialysis patients found no evidence of benefit in overall mortality. Post transplant there is some definite CV benefit, albeit in a patient cohort selected to be at reduced CV risk by virtue of being eligible for organ transplant. The results from the AURORA and SHARP studies are awaited anxiously. SN - 1121-8428 UR - https://www.unboundmedicine.com/medline/citation/19809992/Statin_treatment_for_dyslipidemia_in_chronic_kidney_disease_and_renal_transplantation:_a_review_of_the_evidence_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=19809992.ui DB - PRIME DP - Unbound Medicine ER -