Effects of lipid-lowering therapy with rosuvastatin on atherosclerotic burden in patients with chronic kidney disease.

Author(s): Sawara Y, Takei T, Uchida K, Ogawa T, Yoshida T, Tsuchiya K, Nitta K

Affiliation(s): Department of Medicine, Kidney Center, Tokyo Women's Medical University.

Publication date & source: 2008, Intern Med., 47(17):1505-10. Epub 2008 Sep 1.

Publication type: Comparative Study; Randomized Controlled Trial

OBJECTIVE: Although previous studies suggest that treatment of dyslipidemia with statins reduces mortality and morbidity that are associated with cardiovascular disease, only a few studies have examined the efficacy of statins on atherosclerotic status in patients with chronic kidney disease (CKD). MATERIALS AND METHODS: A 12-month, prospective, randomized study was designed to assess the efficacy of rosuvastatin in reducing circulating atherosclerotic parameters and renal function in patients with CKD. Thirty-eight patients with CKD and LDL cholesterol levels > or =100 mg/dL were randomly assigned to receive 2.5 mg/dL rosuvastatin (group A, n=22) or nonrosuavastatin therapy (group B, n=16). Lipid profile, estimated glomerular filtration rate (eGFR), high sensitivity C-reactive protein (hs-CRP), and intima-media thickness (IMT) were measured before and 12 months after rosuvastatin was added to the treatment. RESULTS: Total cholesterol, low-density lipoprotein cholesterol, remnant-like particle-cholesterol and triglycerides were significantly reduced only in patients who received rosuvastatin. These parameters remained unchanged in patients who were not treated with rosuvastatin. eGFR was significantly increased from 50.7+/-18.7 mL/min/1.73 m(2) to 53.3+/-20.1 mL/min/1.73 m(2) and a significant reduction of U-P was detected in group A patients (0.17+/-0.29 vs. 0.13+/-0.3 g/day; p<0.01). In addition to the hypolipidemic effect, rosuvastatin treatment significantly reduced hs-CRP (p=0.0054). Moreover, maximal IMT at the baseline (1.89+/-0.98 mm) decreased significantly to 1.75+/-0.87 mm at 12 months (p=0.0231). CONCLUSION: Rosuvastatin treatment, in addition to its beneficial effect on cholesterol levels, reduced maximal IMT and modified the inflammatory state of these patients.