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[Effects of statins on delaying progression of chronic kidney disease: a meta-analysis].
Nan Fang Yi Ke Da Xue Xue Bao. 2016 Apr; 36(4):445-54.NF

Abstract

OBJECTIVE

Whether statins can slow down the progression of chronic kidney disease (CKD) remains controversial. We performed a meta-analysis to evaluate the effects of statin therapy on disease progression in adult patients with CKD who did not require dialysis therapy.

METHODS

We searched the electronic databases for relevant randomized controlled trials (RCTs) published by February 2015. Random-effects meta-analysis of RCTs was used to pool the renal outcomes of the patients.

RESULTS

Twenty-eight studies (30 RCTs) involving a total of 45 688 participants were included in the analysis. Compared with the control groups, statins produced no effects in preventing end-stage renal disease (ESRD) [relative risks (RR) 0.98, 95% confidence intervals (CI): 0.91-1.05] and in reducing the risk of doubling of the serum creatinine level (RR 1.43, 95% CI: 0.26-7.79). Statin therapy was associated with a lowered risk of estimated glomerular filtration rate (eGFR) reduction by 25% or more (RR 0.91, 95% CI: 0.83-0.99) and delayed the reduction of eGFR [standardized mean differences (SMD) 0.04, 95% CI: 0.02-0.07]. In subgroup analyses, the benefit of statins on changes in eGFR was statistically significant in patients with moderate CKD (SMD 0.09, 95% CI 0.04-0.13). Among different statins, atorvastatin was associated with a beneficial effect on kidney function (SMD 0.10, 95% CI 0.03-0.17). Patients who received high-intensity statin therapy showed significant changes in eGFR (SMD 0.12, 95% CI: 0.02-0.21).

CONCLUSION

Statin therapies may not prevent ESRD or doubling of serum creatinine level, but can improve GFR or delay the reduction of GFR in CKD patients. The therapeutic effects are associated with the patients' baseline eGFR levels, statin types and therapy intensity.

Authors+Show Affiliations

Liu ZR
Department of Nephrology, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, China. E-mail: liuzongruihao@126.com.
Zhao H
No affiliation info available
Chen YR
No affiliation info available
Tang DD
No affiliation info available
Niu HX
No affiliation info available

MeSH

AdultDisease ProgressionGlomerular Filtration RateHumansHydroxymethylglutaryl-CoA Reductase InhibitorsKidney Failure, ChronicRandomized Controlled Trials as TopicRenal Insufficiency, Chronic

Pub Type(s)

Journal Article
Meta-Analysis
Research Support, Non-U.S. Gov't

Language

chi

PubMed ID

27113168

Citation

Liu, Zong-Rui, et al. "[Effects of Statins On Delaying Progression of Chronic Kidney Disease: a Meta-analysis]." Nan Fang Yi Ke Da Xue Xue Bao = Journal of Southern Medical University, vol. 36, no. 4, 2016, pp. 445-54.
Liu ZR, Zhao H, Chen YR, et al. [Effects of statins on delaying progression of chronic kidney disease: a meta-analysis]. Nan Fang Yi Ke Da Xue Xue Bao. 2016;36(4):445-54.
Liu, Z. R., Zhao, H., Chen, Y. R., Tang, D. D., & Niu, H. X. (2016). [Effects of statins on delaying progression of chronic kidney disease: a meta-analysis]. Nan Fang Yi Ke Da Xue Xue Bao = Journal of Southern Medical University, 36(4), 445-54.
Liu ZR, et al. [Effects of Statins On Delaying Progression of Chronic Kidney Disease: a Meta-analysis]. Nan Fang Yi Ke Da Xue Xue Bao. 2016;36(4):445-54. PubMed PMID: 27113168.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Effects of statins on delaying progression of chronic kidney disease: a meta-analysis]. AU - Liu,Zong-Rui, AU - Zhao,Hao, AU - Chen,Yan-Rong, AU - Tang,Dong-Dong, AU - Niu,Hong-Xin, PY - 2016/4/27/entrez PY - 2016/4/27/pubmed PY - 2016/6/17/medline SP - 445 EP - 54 JF - Nan fang yi ke da xue xue bao = Journal of Southern Medical University JO - Nan Fang Yi Ke Da Xue Xue Bao VL - 36 IS - 4 N2 - OBJECTIVE: Whether statins can slow down the progression of chronic kidney disease (CKD) remains controversial. We performed a meta-analysis to evaluate the effects of statin therapy on disease progression in adult patients with CKD who did not require dialysis therapy. METHODS: We searched the electronic databases for relevant randomized controlled trials (RCTs) published by February 2015. Random-effects meta-analysis of RCTs was used to pool the renal outcomes of the patients. RESULTS: Twenty-eight studies (30 RCTs) involving a total of 45 688 participants were included in the analysis. Compared with the control groups, statins produced no effects in preventing end-stage renal disease (ESRD) [relative risks (RR) 0.98, 95% confidence intervals (CI): 0.91-1.05] and in reducing the risk of doubling of the serum creatinine level (RR 1.43, 95% CI: 0.26-7.79). Statin therapy was associated with a lowered risk of estimated glomerular filtration rate (eGFR) reduction by 25% or more (RR 0.91, 95% CI: 0.83-0.99) and delayed the reduction of eGFR [standardized mean differences (SMD) 0.04, 95% CI: 0.02-0.07]. In subgroup analyses, the benefit of statins on changes in eGFR was statistically significant in patients with moderate CKD (SMD 0.09, 95% CI 0.04-0.13). Among different statins, atorvastatin was associated with a beneficial effect on kidney function (SMD 0.10, 95% CI 0.03-0.17). Patients who received high-intensity statin therapy showed significant changes in eGFR (SMD 0.12, 95% CI: 0.02-0.21). CONCLUSION: Statin therapies may not prevent ESRD or doubling of serum creatinine level, but can improve GFR or delay the reduction of GFR in CKD patients. The therapeutic effects are associated with the patients' baseline eGFR levels, statin types and therapy intensity. SN - 1673-4254 UR - https://www.unboundmedicine.com/medline/citation/27113168/[Effects_of_statins_on_delaying_progression_of_chronic_kidney_disease:_a_meta_analysis]_ DB - PRIME DP - Unbound Medicine ER -