What Effect Do Statins Have on Kidney Disease Outcomes?
Statin use did not reduce the risk for kidney failure events in adults not receiving dialysis but may modestly reduce proteinuria and rate of estimated GFR (eGFR) decline, a study published in the American Journal of Kidney Disease reports.
Current data on the effects of statins on renal disease outcomes have caused controversy. Researchers from Peking University in China aimed to assess the efficacy of statin therapy on renal outcomes by conducting a systematic review and meta-analysis of randomized controlled trials using MEDLINe, EMBASE, and the Cochrane Library Database. They identified adults who were not on dialysis where renal disease outcomes were reported with statin administration for ≥6 months. The included trials evaluated statins vs. control, including placebo, usual care, and various types or doses of statins.
The study outcome measures included kidney failure events, rate of change in estimated GFR per year, change in proteinuria or albuminuria, and for patients with chronic kidney disease, major cardiovascular events. A total of 57 studies (n=144,388) were included for analysis.
Statin therapy did not provide a beneficial effect for kidney failure events (odds ratio [OR] 0.98, 95% CI: 0.87-1.10; P=0.7) or end-stage renal disease events (OR 0.98, 95% CI: 0.90-1.07;P=0.7).
The mean difference in rate of decline for eGFR (0.41mL/min/1.73m^2 slower in statin arm , 95% CI: 0.11-0.70) and standardized mean difference for change in proteinuria or albuminuria (-0.65, 95% CI: -0.94 to -0.37) were statistically significant. Also, treatment with statins significantly reduced the risk for cardiovascular event (OR 0.69, 95% CI: 0.61-0.79; P<0.001) in patients with chronic kidney disease.
Overall, statins did not lower the risk of kidney failure events in adults not on dialysis but it slightly reduced eGFR decline and proteinuria.
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