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Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy--a meta-analysis of 11 randomized controlled trials involving 21,295 participants.
Pharmacol Res. 2013 Jun; 72:35-44.PR

Abstract

The available studies have reported the benefits of statins on all-cause and cardiovascular mortality in chronic kidney disease (CKD) patients. However studies in end-stage renal disease patients on dialysis yielded conflicting results. Therefore, we performed a meta-analysis and provide the most reliable trial data to date on the impact of statin therapy on cardiovascular events and death from all causes in CKD patients. Data from PubMed, Web of Science, Cochrane Library, and Scopus for the years 1966 to October 2012 were searched. The final meta-analysis included 11 randomized controlled trials involving 21,295 participants with CKD. Among them 6857 were on dialysis. The use of statins in subjects with non-dialysis-dependent CKD resulted in a marked reduction in death from all causes (relative risk [RR]: 0.66; 95% confidence interval [CI]: 0.55-0.79; p<0.0001), cardiac causes (RR: 0.69; 95%CI: 0.55-0.68; p=0.0012), cardiovascular events (RR: 0.55; 95%CI: 0.4-0.75; p=0.0001) and stroke (RR: 0.66; 95%CI: 0.5-0.88; p=0.0022). The use of statins in dialysis-dependent CKD patients resulted in a non-significant effect on death from all causes (RR: 0.99; 95%CI: 0.88-1.11; p=0.85) and stroke (RR: 1.31; 95%CI: 0.9-1.89; p>0.05), but had the effect of reducing death from cardiac causes (RR: 0.79; 95%CI: 0.64-0.98; p<0.05) and cardiovascular events (RR: 0.81; 95%CI: 0.7-0.94; p<0.05). In conclusion, the use of statins should be indicated in cardiovascular disease prevention especially in patients with non-dialysis-dependent CKD. According to the very limited data the obtained results suggest caution in expecting a reduction in cardiovascular events in patients on dialysis.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Barylski M
Department of Internal Medicine and Cardiological Rehabilitation, Medical University of Lodz, Poland.
Nikfar S
No affiliation info available
Mikhailidis DP
No affiliation info available
Toth PP
No affiliation info available
Salari P
No affiliation info available
Ray KK
No affiliation info available
Pencina MJ
No affiliation info available
Rizzo M
No affiliation info available
Rysz J
No affiliation info available
Abdollahi M
No affiliation info available
Nicholls SJ
No affiliation info available
Banach M
No affiliation info available
Lipid and Blood Pressure Meta-Analysis Collaboration Group
No affiliation info available

MeSH

Cardiovascular DiseasesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsRandomized Controlled Trials as TopicRenal DialysisRenal Insufficiency, ChronicStroke

Pub Type(s)

Journal Article
Meta-Analysis

Language

eng

PubMed ID

23542730

Citation

Barylski, Marcin, et al. "Statins Decrease All-cause Mortality Only in CKD Patients Not Requiring Dialysis Therapy--a Meta-analysis of 11 Randomized Controlled Trials Involving 21,295 Participants." Pharmacological Research, vol. 72, 2013, pp. 35-44.
Barylski M, Nikfar S, Mikhailidis DP, et al. Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy--a meta-analysis of 11 randomized controlled trials involving 21,295 participants. Pharmacol Res. 2013;72:35-44.
Barylski, M., Nikfar, S., Mikhailidis, D. P., Toth, P. P., Salari, P., Ray, K. K., Pencina, M. J., Rizzo, M., Rysz, J., Abdollahi, M., Nicholls, S. J., & Banach, M. (2013). Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy--a meta-analysis of 11 randomized controlled trials involving 21,295 participants. Pharmacological Research, 72, 35-44. https://doi.org/10.1016/j.phrs.2013.03.007
Barylski M, et al. Statins Decrease All-cause Mortality Only in CKD Patients Not Requiring Dialysis Therapy--a Meta-analysis of 11 Randomized Controlled Trials Involving 21,295 Participants. Pharmacol Res. 2013;72:35-44. PubMed PMID: 23542730.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy--a meta-analysis of 11 randomized controlled trials involving 21,295 participants. AU - Barylski,Marcin, AU - Nikfar,Shekoufeh, AU - Mikhailidis,Dimitri P, AU - Toth,Peter P, AU - Salari,Pooneh, AU - Ray,Kausik K, AU - Pencina,Michael J, AU - Rizzo,Manfredi, AU - Rysz,Jacek, AU - Abdollahi,Mohammad, AU - Nicholls,Stephen J, AU - Banach,Maciej, AU - ,, Y1 - 2013/03/28/ PY - 2013/03/07/received PY - 2013/03/20/revised PY - 2013/03/20/accepted PY - 2013/4/2/entrez PY - 2013/4/2/pubmed PY - 2013/11/10/medline SP - 35 EP - 44 JF - Pharmacological research JO - Pharmacol Res VL - 72 N2 - The available studies have reported the benefits of statins on all-cause and cardiovascular mortality in chronic kidney disease (CKD) patients. However studies in end-stage renal disease patients on dialysis yielded conflicting results. Therefore, we performed a meta-analysis and provide the most reliable trial data to date on the impact of statin therapy on cardiovascular events and death from all causes in CKD patients. Data from PubMed, Web of Science, Cochrane Library, and Scopus for the years 1966 to October 2012 were searched. The final meta-analysis included 11 randomized controlled trials involving 21,295 participants with CKD. Among them 6857 were on dialysis. The use of statins in subjects with non-dialysis-dependent CKD resulted in a marked reduction in death from all causes (relative risk [RR]: 0.66; 95% confidence interval [CI]: 0.55-0.79; p<0.0001), cardiac causes (RR: 0.69; 95%CI: 0.55-0.68; p=0.0012), cardiovascular events (RR: 0.55; 95%CI: 0.4-0.75; p=0.0001) and stroke (RR: 0.66; 95%CI: 0.5-0.88; p=0.0022). The use of statins in dialysis-dependent CKD patients resulted in a non-significant effect on death from all causes (RR: 0.99; 95%CI: 0.88-1.11; p=0.85) and stroke (RR: 1.31; 95%CI: 0.9-1.89; p>0.05), but had the effect of reducing death from cardiac causes (RR: 0.79; 95%CI: 0.64-0.98; p<0.05) and cardiovascular events (RR: 0.81; 95%CI: 0.7-0.94; p<0.05). In conclusion, the use of statins should be indicated in cardiovascular disease prevention especially in patients with non-dialysis-dependent CKD. According to the very limited data the obtained results suggest caution in expecting a reduction in cardiovascular events in patients on dialysis. SN - 1096-1186 UR - https://www.unboundmedicine.com/medline/citation/23542730/Statins_decrease_all_cause_mortality_only_in_CKD_patients_not_requiring_dialysis_therapy__a_meta_analysis_of_11_randomized_controlled_trials_involving_21295_participants_ DB - PRIME DP - Unbound Medicine ER -