Efficacy analysis of the lipid-lowering and renoprotective effects of rosuvastatin in patients with chronic kidney disease

Endocr J. 2011;58(8):663-74. doi: 10.1507/endocrj.k11e-080. Epub 2011 Jun 14.

Abstract

We aimed to assess the effects of rosuvastatin treatment on lipid levels, albuminuria, and kidney function in patients with chronic kidney disease (CKD). We conducted a prospective, open-label, study of 91 patients with CKD, low-density lipoprotein cholesterol (LDL-C) levels > 120 mg/dL, and well-controlled blood pressure who were undergoing treatment with renin-angiotensin system inhibitors. Subjects were treated with 2.5 mg/day rosuvastatin, which was increased to 10 mg/day for the 24-week study period. Rosuvastatin effectively reduced total cholesterol, LDL-C, triglycerides, non-high density lipoprotein cholesterol (non-HDL-C) levels, and the LDL-C/HDL-C ratio. Although there was no significant change in the estimated glomerular filtration rate (eGFR), serum cystatin C levels and urinary albumin/creatinine ratio were significantly decreased. Subjects were divided into 2 groups: with and without diabetes mellitus (DM). Percent changes of HDL-C, C-reactive protein (CRP), and malondialdehyde-modified (MDA)-LDL were significantly higher in the DM group than in the non-DM group. Furthermore, when the subjects were divided into 2 groups based on eGFR levels (60 mL/min/1.73 m(2) or more, normal-GFR group; less than 60 mL/min/1.73 m(2), decreased-GFR group), the percent reduction of non-HDL-C, CRP, MDA-LDL levels, and albuminuria of DM subjects in the decreased-GFR group were significantly higher than those in the non-DM subjects. Multivariate analysis identified a change in cystatin C to be associated with decreased albuminuria during rosuvastatin treatment. Rosuvastatin administration reduced albuminuria, serum cystatin C levels, and inflammation, and improved lipid profiles, regardless of the presence or absence of DM, and the degree of the eGFR.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Blood Glucose / drug effects
  • Blood Glucose / physiology
  • Blood Pressure / drug effects
  • Blood Pressure / physiology
  • Cytoprotection / drug effects*
  • Diabetic Nephropathies / blood
  • Diabetic Nephropathies / drug therapy
  • Diabetic Nephropathies / physiopathology
  • Female
  • Fluorobenzenes / adverse effects
  • Fluorobenzenes / pharmacology*
  • Fluorobenzenes / therapeutic use*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypolipidemic Agents / adverse effects
  • Hypolipidemic Agents / pharmacology*
  • Hypolipidemic Agents / therapeutic use
  • Kidney / drug effects
  • Kidney / physiopathology
  • Kidney Failure, Chronic / blood
  • Kidney Failure, Chronic / drug therapy*
  • Kidney Failure, Chronic / physiopathology
  • Male
  • Middle Aged
  • Pyrimidines / adverse effects
  • Pyrimidines / pharmacology*
  • Pyrimidines / therapeutic use*
  • Rosuvastatin Calcium
  • Sulfonamides / adverse effects
  • Sulfonamides / pharmacology*
  • Sulfonamides / therapeutic use*
  • Treatment Outcome

Substances

  • Blood Glucose
  • Fluorobenzenes
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypolipidemic Agents
  • Pyrimidines
  • Sulfonamides
  • Rosuvastatin Calcium