Effects of atorvastatin on triglyceride-rich lipoproteins, low-density lipoprotein subclass, and C-reactive protein in hemodialysis patients

Ikejiri, Ayako; Hirano, Tsutomu; Murayama, Satoru; Yoshino, Gen; Gushiken, Natsuko; Hyodo, Toru; Taira, Takayasu; Adachi, Mitsuru

doi:10.1016/j.metabol.2004.01.011

Cited by 34 publications

(32 citation statements)

References 32 publications

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“…The lipid-lowering effects of atorvastatin were equivalent to those observed in the general population and previous works involving MHD patients [20]. No significant clinical adverse effects, such as hepatotoxicity and muscle toxicity, were observed in patients receiving statin therapy.…”

Section: Discussionsupporting

confidence: 73%

“…Proinflammatory cytokines, such as IL-6 and TNF-α, were suppressed during the study period. The lipid-lowering effects of atorvastatin in MHD patients are similar in the general population without significant adverse effects [20]. These observations imply that atorvastatin improves ESA hyporesponsiveness through correcting chronic inflammation by series follow-up of proinflammatory cytokines in MHD patients.…”

Section: Discussionmentioning

confidence: 87%

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Atorvastatin Increases Erythropoietin-Stimulating Agent Hyporesponsiveness in Maintenance Hemodialysis Patients: Role of Anti-Inflammation Effects

Chiang¹,

Yang²,

Peng³

et al. 2008

Am J Nephrol

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Erythropoietin-stimulating agent (ESA) hyporesponsiveness is aggravated by chronic inflammation in maintenance hemodialysis (MHD) patients. Dyslipidemia is prevalent in MHD patients. Statin therapy has been demonstrated to not only be effective in lowering lipid levels, but also numerous pleiotropic effects including anti-inflammatory, anti-fibrotic and endothelial function improvement. Recently, a retrospective study has shown that statin therapy decreases ESA requirements in MHD patients. We conducted a prospective study to analyze the effect of statin therapy on ESA hyporesponsiveness, and especially emphasized its anti-inflammatory benefits in MHD patients. This prospective study enrolled 30 patients with baseline cholesterol >220 mg/dl. Low-dose atorvastatin (10 mg/day) was prescribed for 12 weeks. We prospectively recorded patients’ biochemistry and hematological profiles, ESA prescription and some inflammatory markers at baseline, 4 weeks and 12 weeks. Statistically significant changes were noted after 4 and 12 weeks of statin therapy for cholesterol (272.5 ± 41.1 to 184.4 ± 37.6 and 196.4 ± 40.2 mg/dl, p < 0.05) and ESA hyporesponsiveness, which demonstrated as erythropoietin to hematocrit ratio (EHR) (129.3 ± 58.2 to 122.3 ± 53.5 and 121.0 ± 53.3 EPO U/Hct/week, p < 0.05). Mean values for proinflammatory cytokines included interleukin-6 and tumor necrotic factor-α levels decreased by 30.8 and 10.6%, respectively. Thus, these data suggest that statin therapy may improve ESA hyporesponsiveness in dialysis patients. This improvement in ESA hyporesponsiveness is associated with the effects of statins on inflammation.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 87%

Atorvastatin Increases Erythropoietin-Stimulating Agent Hyporesponsiveness in Maintenance Hemodialysis Patients: Role of Anti-Inflammation Effects

Chiang¹,

Yang²,

Peng³

et al. 2008

Am J Nephrol

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“…There are more data available on the effects of atorvastatin on LDL quality in patients with diabetes, however these are conflicting. An increase in LDL size was observed in monotherapy at different dosages, including high (80mg/d for 2 months) and low (10mg/d for 3 months) dosages [58][59][60][61]. By contrast, there was a lack of efficiency of atorvastatin concerning LDL particle size in other studies, including recently published data [62][63][64][65].…”

Section: Lipid Lowering Agents Targeting Ldl Particle Distributionmentioning

confidence: 99%

Small dense low-density lipoprotein particles: priority as a treatment target in Type 2 diabetes?

Gerber¹,

Spinas²,

Berneis³

2012

Diabetes Management

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During the past two decades, the importance of the quality of low-density lipoprotein (LDL) particles -in addition to its quantity -has become of increasing interest. The risk of cardiovascular events was recognized to be closely linked to a predominance of small, dense LDL particles. In addition, in patients with Type 2 diabetes mellitus, the disease itself and its severity (in particular the degree of insulin resistance) is associated with this subclass of LDL particles. Lipid lowering as well as antihyperglycemic drugs have been evaluated in many studies concerning their effect on LDL particle size. It has increasingly been recognized that a reduction of LDL quantity is not necessarily associated with a beneficial effect on LDL quality. Advances in the understanding of alterations in LDL quality may therefore influence the choice of the therapeutic regimen in patients with diabetes in the future. SummaryDuring the last two decades, the importance of the quality of low-density lipoprotein (LDL) particles -in addition to its quantity -has become of increasing interest. The risk of cardiovascular events was recognized to be closely linked to a predominance of small, dense LDL particles. In addition, in patients with type 2 diabetes mellitus, the disease itself and its severity (in particular the degree of insulin resistance) is associated with this subclass of LDL particles. Lipid lowering as well as antihyperglycemic drugs have been evaluated in many studies concerning their effect on LDL particle size. It has increasingly been recognized that a reduction of LDL quantity is not necessarily associated with a beneficial effect on LDL quality. Advances in the understanding of alterations in LDL quality may therefore influence the choice of the therapeutic regimen in patients with diabetes in the future.

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“…All statins available today are excreted through bile. Effective and safe use in Japanese dialysis patients has been reported for pravastatin (88), simvastatin (89), fluvastatin (90), and atorvastatin (91). These statins reduce plasma LDL cholesterol by approximately 25-40%.…”

Section: The Nkf K/doqi Has Published the Clinical Practice Guidelinementioning

confidence: 99%

Chronic Kidney Disease as a Metabolic Syndrome with Malnutrition-Need for Strict Control of Risk Factors

Shoji

Nishizawà

2005

Intern. Med.

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Effects of atorvastatin on triglyceride-rich lipoproteins, low-density lipoprotein subclass, and C-reactive protein in hemodialysis patients

Cited by 34 publications

References 32 publications

Atorvastatin Increases Erythropoietin-Stimulating Agent Hyporesponsiveness in Maintenance Hemodialysis Patients: Role of Anti-Inflammation Effects

Atorvastatin Increases Erythropoietin-Stimulating Agent Hyporesponsiveness in Maintenance Hemodialysis Patients: Role of Anti-Inflammation Effects

Small dense low-density lipoprotein particles: priority as a treatment target in Type 2 diabetes?

Chronic Kidney Disease as a Metabolic Syndrome with Malnutrition-Need for Strict Control of Risk Factors

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