Effect of Intensive Lipid Lowering with Atorvastatin on Renal Function in Patients with Coronary Heart Disease

Shepherd, James; Kastelein, John J.P.; Bittner, Vera; Deedwania, Prakash; Breazna, Andrei; Dobson, Stephen L.; Wilson, Daniel J.; Zuckerman, Andrea; Wenger, Nanette K.

doi:10.2215/cjn.04371206

Cited by 285 publications

(236 citation statements)

References 50 publications

(58 reference statements)

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“…Earlier small studies have suggested that lipid variables might be involved in the development and progression of diabetic nephropathy [10,11], but it can also be argued that the lipid abnormalities are merely a consequence of albuminuria. Recently, a large prospective clinical trial showed an improvement of renal function in patients treated with atorvastatin [12]. However, data on the effect of lipid-lowering agents on albuminuria are more controversial [13,14].…”

Section: Introductionmentioning

confidence: 99%

Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes

et al. 2009

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Aims/hypothesis We studied the impact of baseline lipid variables on the progression of renal disease in a large nationwide prospective cohort of patients with type 1 diabetes. Methods A total of 2,304 adult patients with type 1 diabetes and available lipid profiles participating in the Finnish Diabetic Nephropathy Study (FinnDiane) were evaluated. Data on progression of renal disease were verified from medical files and patients were followed for 5.4±2.0 (mean ± SD) years. Results High triacylglycerol, apolipoprotein (Apo) B, ApoA-II and HDL 3 -cholesterol concentrations predicted incident microalbuminuria. Progression to macroalbuminuria was predicted by high triacylglycerol and ApoB. When AER was entered into the model, triacylglycerol was no longer an independent predictor, but when patients with normal AER and microalbuminuria at baseline were pooled, triacylglycerol, HbA 1c , male sex and AER were all independent predictors of renal disease. High total cholesterol, LDLcholesterol, non-HDL-cholesterol and triacylglycerol as well as low HDL-cholesterol, HDL 2 -cholesterol, ApoA-I and ApoA-II concentrations were predictive of progression to end-stage renal disease. However, when estimated GFR was entered into the model, only total cholesterol remained an independent predictor of progression. Conclusions/interpretation Lipid abnormalities, particularly high triacylglycerol concentrations, increase the risk of progression of renal disease.

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Section: Introductionmentioning

confidence: 99%

Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes

et al. 2009

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“…Consistent with this view, increasing evidence suggests that statins are also associated with a reduced risk of hepatocellular carcinoma 128 . On the other hand, post-hoc analyses of randomized clinical trials have shown that atorvastatin may be nephroprotective 129,130 . To date, however, there are no large randomized clinical trials testing the long-term effects of statins on histological liver endpoints in patients with NAFLD.…”

Section: Management and Treatment Options For Nafldmentioning

confidence: 99%

Non-alcoholic fatty liver disease: an emerging driving force in chronic kidney disease

2017

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“…Statin treatment is associated with increased eGFR or CCr as compared with a placebo in pot-hoc analyses of primary 69,70) and secondary prevention trials with statin 80,81) . Studies performed in Japan also provided similar results.…”

Section: Possible Reno-protective Effects Of Lipid-lowering Treatmentmentioning

confidence: 99%

“…Studies performed in Japan also provided similar results. A higher dose of statin was associated with a more impressive increase of eGFR in a post-hoc analysis of the Treating To New target trial 81) . Some studies indicate that the increase in eGFR was greater in subjects with lower eGFR at baseline.…”

Section: Possible Reno-protective Effects Of Lipid-lowering Treatmentmentioning

confidence: 99%

Chronic Kidney Disease, Dyslipidemia, and Atherosclerosis

Shoji

Abe

Matsuo³

et al. 2012

JAT

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Patients with chronic kidney disease (CKD) are at an increased risk not only for end-stage kidney disease (ESKD) but also for cardiovascular disease (CVD). In this review article, we summarize the current evidence of CKD as a high-risk condition for CVD based on reports from Japan and other countries to draw attention to the close clinical association between CKD and CVD. Several epidemiologic studies have shown that the presence of CKD and reduced renal function are independent predictors of CVD also in Japan. According to a post-hoc analysis of CASE-J, the power of CKD as a predictor of CVD is as strong as diabetes mellitus and a previous history of ischemic heart disease. CKD worsens classical risk factors including hypertension and dyslipidemia, and dyslipidemia is associated with increased thickness and stiffness of large arteries independent of major confounders. A post-hoc analysis of MEGA indicates that lipid-lowering therapy with statins reduces the risk of CVD, and that it appears to be more efficacious in patients with than without CKD. These reports from Japan and other countries suggest that CKD should be regarded as a high-risk condition comparable to diabetes mellitus, and that strict control of dyslipidemia would be beneficial in preventing CVD, at least early stages of CKD.

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Effect of Intensive Lipid Lowering with Atorvastatin on Renal Function in Patients with Coronary Heart Disease

Cited by 285 publications

References 50 publications

Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes

Lipid abnormalities predict progression of renal disease in patients with type 1 diabetes

Non-alcoholic fatty liver disease: an emerging driving force in chronic kidney disease

Chronic Kidney Disease, Dyslipidemia, and Atherosclerosis

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