A Trial of Pitavastatin Versus Rosuvastatin for Dyslipidemia in Chronic Kidney Disease

Abe, Masanori; Maruyama, Noriaki; Maruyama, Takashi; Okada, Kazuyoshi; Soma, Masayoshi

doi:10.5551/jat.29264

Cited by 6 publications

(3 citation statements)

References 31 publications

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“…Although there was a limitation that it was difficult to obtain accurate information of medication, such as doses and durations of these drugs in the questionnaire, it is suggested that careful observation in eGFR decline may be needed in non-CKD patients with antihypertensive drugs. Medications for dyslipidemia were not significantly associated with an eGFR decline in non-CKD participants, consistent with previous reports 28 ) .…”

Section: Discussionsupporting

confidence: 91%

Investigation of Metabolic Factors Associated with eGFR Decline Over 1 Year in a Japanese Population without CKD

Hayashi

Takayama

Abe

et al. 2017

J Atheroscler Thromb

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Aim: Early intervention before the progression of chronic kidney disease (CKD) is essential to prevent end-stage renal disease (ESRD) and cardiovascular complications. This study evaluated the correlation between metabolic and lifestyle-related factors and the decline of estimated glomerular filtration rate (eGFR) over 1 year in a Japanese population without CKD.Methods: Subjects who received two consecutive annual health checkups from 2013 to 2015 were involved. Factors associated with eGFR decline were identified using multiple regression models.Results: A total of 2531 subjects aged 58.9 ± 11.7 years old were included in this study. Baseline levels of HDL-C and ApoA1 correlated with the eGFR decline over 1 year defined as eGFR reduction rate of 15% or more and/or eGFR at the next year < 60 ml/min/m2 (odds ratio (OR) 0.87 (per 10 mg/dl); 95% CI, 0.80–0.94; p = 0.0012, 0.90 (per 10 mg/dl); 0.86–0.96; p = 0.0004, respectively). A U-shaped relationship between the eGFR decline and HDL-C or ApoA1 levels was not observed in non-CKD population of this study. Metabolic syndrome was significantly associated with eGFR decline (OR 1.32; 1.04–1.67; p = 0.0205), although obesity-related factors did not show a significant correlation with eGFR decline over 1 year.Conclusion: Low HDL-C and ApoA1 levels significantly correlated with eGFR decline in a short period of 1 year. Metabolic syndrome also showed a significant association with eGFR decline. This study suggests the importance of hypertension and low HDL-C in the metabolic syndrome effect on eGFR decline rather than obesity in non-CKD population.

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Section: Discussionsupporting

confidence: 91%

Investigation of Metabolic Factors Associated with eGFR Decline Over 1 Year in a Japanese Population without CKD

Hayashi

Takayama

Abe

et al. 2017

J Atheroscler Thromb

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“…Of these 42 publications, 40 were in English, one was Russian 27 , and one Japanese 28 . In total, 40 RCTs reported about the effect of statins on change of eGFR 13–15,27,29–63 , of which 30 compared a statin to control, and 10 compared two or more statins with each other. The effect of statins on proteinuria was reported in 25 RCTs 13,14,28,29,32–34,36,39,45,46,48–54,57,60,62–65 , of which 19 compared a statin to control intervention, and six compared two or more statins.…”

Section: Resultsmentioning

confidence: 99%

Effect of different types of statins on kidney function decline and proteinuria: a network meta-analysis

Esmeijer

Dekkers

Fijter

et al. 2019

Sci Rep

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Previous studies showed that statins reduce the progression of kidney function decline and proteinuria, but whether specific types of statins are more beneficial than others remains unclear. We performed a network meta-analysis of randomized controlled trials (RCT) to investigate which statin most effectively reduces kidney function decline and proteinuria. We searched MEDLINE, Embase, Web of Science, and the Cochrane database until July 13, 2018, and included 43 RCTs (>110,000 patients). We performed a pairwise random-effects meta-analysis and a network meta-analysis according to a frequentist approach. We assessed network inconsistency, publication bias, and estimated for each statin the probability of being the best treatment. Considerable heterogeneity was present among the included studies. In pairwise meta-analyses, 1-year use of statins versus control reduced kidney function decline by 0.61 (95%-CI: 0.27; 0.95) mL/min/1.73 m2 and proteinuria with a standardized mean difference of −0.58 (95%-CI:−0.88; −0.29). The network meta-analysis for the separate endpoints showed broad confidence intervals due to the small number available RCTs for each individual comparison. In conclusion, 1-year statin use versus control attenuated the progression of kidney function decline and proteinuria. Due to the imprecision of individual comparisons, results were inconclusive as to which statin performs best with regard to renal outcome.

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“…All statins may be administered to patients with mild to moderate renal insufficiency; all require modified dosing for patients with substantial or severe renal disease [23]. The other study suggested that Rosuvastatin 2.5 mg had superior lipid lowering and cost effectiveness in dyslipidemic patients with concurrent CKD [24]. Moreover, rhabdomyolysis can occur as a result of electrolyte abnormalities (e.g.…”

Section: Discussionmentioning

confidence: 99%

Iatrogenic AKI and Agranulocytosis: a Cautious Tale of Medication Use in Elderly Patients

Qin¹,

Cang²,

Liu³

et al. 2017

J Clin Exp Nephrol

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A 83-year-old female patient suffered from acute kidney injury a month after percutaneous coronary intervention. Two weeks before hospitalization, she experienced nausea and intermittent watery diarrhea. Laboratory test showed high levels of serum creatine kinase and lactate dehydrogenase, which were remarkably decreased after ceasing rosuvastatin and valsartan treatment. Despite the recovery of renal function, unfortunately one week later, she was diagnosed with agranulocytosis because of antibiotic therapy. When we stopped meropenem and switched to granulocyto-colony stimulating factor treatment, her white blood cell count returned to a normal range. In our case, both rhabdomyolysis and agranulocytosis were induced by drugs. We provided a literature review of the causes of acute kidney injury and the pathogenesis of rhabdomyolysis and agranulocytosis. We discussed how drugs might lead to these complications. This case highlights the need to be aware of the potential side effects of drugs, especially those given to elderly patients who are likely to be receiving several medications concurrently for managing chronic diseases.

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A Trial of Pitavastatin Versus Rosuvastatin for Dyslipidemia in Chronic Kidney Disease

Cited by 6 publications

References 31 publications

Investigation of Metabolic Factors Associated with eGFR Decline Over 1 Year in a Japanese Population without CKD

Investigation of Metabolic Factors Associated with eGFR Decline Over 1 Year in a Japanese Population without CKD

Effect of different types of statins on kidney function decline and proteinuria: a network meta-analysis

Iatrogenic AKI and Agranulocytosis: a Cautious Tale of Medication Use in Elderly Patients

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