The role of statins in chronic kidney disease

Rajiv Agarwal, Timothy M. Curley

Research output: Contribution to journalReview article

23 Scopus citations

Abstract

Chronic kidney disease is associated with cardiovascular event rates that are at least as high as in patients with established atherosclerotic cardiovascular disease or in those with diabetes mellitus. Chronic kidney disease is therefore considered a cardiovascular disease risk equivalent. Treatment of dyslipidemia, which is very common in this population and reflects the pattern seen in the metabolic syndrome, reduces cardiovascular events in patients with chronic kidney disease. Thus, patients with chronic kidney disease should be evaluated and treated for dyslipidemia. Dyslipidemia is a risk factor for the development of impaired kidney function. Dyslipidemia is also associated with progressive renal disease in subjects with no overt renal disease, as well as those with diabetic and nondiabetic kidney disease. Although definitive randomized controlled trials are lacking, the collective evidence suggests that treatment of dyslipidemia is associated with less decline in renal function. The use of potent statins in high doses can lead to transient proteinuria via impairment of proximal tubular receptor-mediated endocytosis, in a dose-dependent manner. Over the long term, however, the use of statins results in a reduction in proteinuria and in the rate of decline of renal function. Several large definitive trials that are currently underway to examine the safety and efficacy of statins in cardiovascular and renal protection should provide more definitive answers on the role of these drugs in this very high risk population.

Original languageEnglish (US)
Pages (from-to)69-81
Number of pages13
JournalAmerican Journal of the Medical Sciences
Volume330
Issue number2
DOIs
StatePublished - Aug 2005

Keywords

  • Chronic kidney disease
  • Lipids
  • Proteinuria
  • Statins

ASJC Scopus subject areas

  • Medicine(all)

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