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Effects of atorvastatin on renal function in patients with dyslipidemia and chronic kidney disease: assessment of clinical usefulness in CKD patients with atorvastatin (ASUCA) trial.
Clin Exp Nephrol. 2017 Jun; 21(3):417-424.CE

Abstract

BACKGROUND

Dyslipidemia is a risk factor for the progression of chronic kidney disease (CKD). While conventional lipid lowering therapy provides a benefit to CKD management, the effect of statins on eGFR remains unclear.

METHODS

A prospective, multi-center, open-labeled, randomized trial. Total of 349 CKD patients with hyperlipidemia were randomized into 2 groups, and followed for 2 years. Group A included patients who were treated with atorvastatin. Group C were treated with conventional lipid lowering drugs other than statin. Primary endpoint was changes in eGFR. Secondary endpoints included changes in urinary albumin excretion, serum LDL-C, serum triglyceride, cardio-vascular events and all-cause mortality.

RESULTS

As the primary endpoint, eGFR decreased by 2.3 ml/min/1.73 m2 in Group A and by 2.6 ml/min/1.73 m2 in Group C, indicating that there was no difference in change of eGFR between the two groups. As secondary endpoints, atorvastatin succeeded to reduce serum LDL-C level significantly and rapidly, but conventional therapy did not. In fact, mean LDL-C level did not reach the target level of 100 mg/dl in Group C. Serum triglyceride was lowered only by atorvastatin, but not conventional drugs. The number of cardiovascular events and all-cause mortality did not differ between in two groups.

CONCLUSION

The ASUCA (Assessment of Clinical Usefulness in CKD Patients with Atorvastatin) trial demonstrated that atorvastatin failed to exhibit reno-protections compared to conventional therapy in Japanese patients with dyslipidemia and CKD. It would be due in part to the ability of atorvastatin to more potently reduce serum LDL and triglycerides compared to conventional therapy.

Authors+Show Affiliations

Asahi Rosai Hospital, Owariasahi, Aichi, Japan.Department of EBM Research, Institute of Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan. kasa@naramed-u.ac.jp. Institute for Clinical and Translational Science, Nara Medical University Hospital, 840 Shijo-cho, Kashihara, Nara, Japan. kasa@naramed-u.ac.jp.Department of EBM Research, Institute of Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.Department of EBM Research, Institute of Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.Department of EBM Research, Institute of Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.Department of EBM Research, Institute of Advancement of Clinical and Translational Science, Kyoto University Hospital, Kyoto, Japan.Department of Biostatistics, Kyoto University School of Public Health, Kyoto, Japan.Department of Food and Nutritional Science, Kobe Women's Junior College, Kobe, Japan.Department of Medical Ethics/Medical Genetics, Kyoto University School of Public Health, Kyoto, Japan.Medical Innovation Center, Kyoto University Graduate School of Medicine, Kyoto, Japan.

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

27392909

Citation

Kimura, Genjiro, et al. "Effects of Atorvastatin On Renal Function in Patients With Dyslipidemia and Chronic Kidney Disease: Assessment of Clinical Usefulness in CKD Patients With Atorvastatin (ASUCA) Trial." Clinical and Experimental Nephrology, vol. 21, no. 3, 2017, pp. 417-424.
Kimura G, Kasahara M, Ueshima K, et al. Effects of atorvastatin on renal function in patients with dyslipidemia and chronic kidney disease: assessment of clinical usefulness in CKD patients with atorvastatin (ASUCA) trial. Clin Exp Nephrol. 2017;21(3):417-424.
Kimura, G., Kasahara, M., Ueshima, K., Tanaka, S., Yasuno, S., Fujimoto, A., Sato, T., Imamoto, M., Kosugi, S., & Nakao, K. (2017). Effects of atorvastatin on renal function in patients with dyslipidemia and chronic kidney disease: assessment of clinical usefulness in CKD patients with atorvastatin (ASUCA) trial. Clinical and Experimental Nephrology, 21(3), 417-424. https://doi.org/10.1007/s10157-016-1304-6
Kimura G, et al. Effects of Atorvastatin On Renal Function in Patients With Dyslipidemia and Chronic Kidney Disease: Assessment of Clinical Usefulness in CKD Patients With Atorvastatin (ASUCA) Trial. Clin Exp Nephrol. 2017;21(3):417-424. PubMed PMID: 27392909.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effects of atorvastatin on renal function in patients with dyslipidemia and chronic kidney disease: assessment of clinical usefulness in CKD patients with atorvastatin (ASUCA) trial. AU - Kimura,Genjiro, AU - Kasahara,Masato, AU - Ueshima,Kenji, AU - Tanaka,Sachiko, AU - Yasuno,Shinji, AU - Fujimoto,Akira, AU - Sato,Toshiya, AU - Imamoto,Miyuki, AU - Kosugi,Shinji, AU - Nakao,Kazuwa, Y1 - 2016/07/08/ PY - 2016/02/12/received PY - 2016/06/27/accepted PY - 2016/7/10/pubmed PY - 2018/4/3/medline PY - 2016/7/10/entrez KW - Chronic kidney disease (CKD) KW - Hyperlipidemia KW - Low-density lipoprotein cholesterol (LDL-C) KW - Reno-protective effect KW - Statins SP - 417 EP - 424 JF - Clinical and experimental nephrology JO - Clin Exp Nephrol VL - 21 IS - 3 N2 - BACKGROUND: Dyslipidemia is a risk factor for the progression of chronic kidney disease (CKD). While conventional lipid lowering therapy provides a benefit to CKD management, the effect of statins on eGFR remains unclear. METHODS: A prospective, multi-center, open-labeled, randomized trial. Total of 349 CKD patients with hyperlipidemia were randomized into 2 groups, and followed for 2 years. Group A included patients who were treated with atorvastatin. Group C were treated with conventional lipid lowering drugs other than statin. Primary endpoint was changes in eGFR. Secondary endpoints included changes in urinary albumin excretion, serum LDL-C, serum triglyceride, cardio-vascular events and all-cause mortality. RESULTS: As the primary endpoint, eGFR decreased by 2.3 ml/min/1.73 m2 in Group A and by 2.6 ml/min/1.73 m2 in Group C, indicating that there was no difference in change of eGFR between the two groups. As secondary endpoints, atorvastatin succeeded to reduce serum LDL-C level significantly and rapidly, but conventional therapy did not. In fact, mean LDL-C level did not reach the target level of 100 mg/dl in Group C. Serum triglyceride was lowered only by atorvastatin, but not conventional drugs. The number of cardiovascular events and all-cause mortality did not differ between in two groups. CONCLUSION: The ASUCA (Assessment of Clinical Usefulness in CKD Patients with Atorvastatin) trial demonstrated that atorvastatin failed to exhibit reno-protections compared to conventional therapy in Japanese patients with dyslipidemia and CKD. It would be due in part to the ability of atorvastatin to more potently reduce serum LDL and triglycerides compared to conventional therapy. SN - 1437-7799 UR - https://www.unboundmedicine.com/medline/citation/27392909/Effects_of_atorvastatin_on_renal_function_in_patients_with_dyslipidemia_and_chronic_kidney_disease:_assessment_of_clinical_usefulness_in_CKD_patients_with_atorvastatin__ASUCA__trial_ DB - PRIME DP - Unbound Medicine ER -