Low-dose atorvastatin in severe chronic kidney disease patients: A randomized, controlled endpoint study

Autor:	B Isaksson, E Dimeny, Henrik Hadimeri, L Mikaelsson, A-M Wikdahl, Marie Eriksson, E Olausson, M Brännström, Bernd Stegmayr, B Ingman, K Lindberger, A Ekspong, Britt C. Persson, Benny Holmberg, G Johansson, B Granroth, Lennart Lundberg, Crougneau, KC Gröntoft, Hans Stenlund, S Bucht
Rok vydání:	2005
Předmět:	Male Nephrology medicine.medical_specialty Randomization Urology medicine.medical_treatment Atorvastatin Myocardial Infarction macromolecular substances Peritoneal dialysis Internal medicine Epidemiology medicine Humans Pyrroles Prospective Studies Angioplasty Balloon Coronary Coronary Artery Bypass Risk factor Aged Dose-Response Relationship Drug business.industry medicine.disease Endocrinology Cardiovascular Diseases Heptanoic Acids Kidney Failure Chronic Female Hemodialysis Hydroxymethylglutaryl-CoA Reductase Inhibitors business Kidney disease medicine.drug
Zdroj:	Scandinavian Journal of Urology and Nephrology. 39:489-497
ISSN:	1651-2065 0036-5599
DOI:	10.1080/00365590500329304
Popis:	There have been no endpoint studies with statins for patients with severe renal failure. The purpose of this prospective, open, randomized, controlled study was to investigate whether atorvastatin (10 mg/day) would alter cardiovascular endpoints and the overall mortality rate of patients with chronic kidney disease stage 4 or 5 (creatinine clearance30 ml/min).The study subjects comprised 143 patients who were randomized either to placebo (controls; n=73; mean age 69.5 years) or to treatment with atorvastatin (n=70; mean age 67.9 years). The patients included were either non-dialysis (n=33), haemodialysis (n=97) or peritoneal dialysis (n=13) patients. Analysis focused on the primary endpoints of all-cause mortality, non-lethal acute myocardial infarction, coronary artery bypass graft surgery and percutaneous transluminal coronary angioplasty. Statistical analysis for endpoint data was mainly by intention-to-treat.Primary endpoints occurred in 74% of the subjects. There was no difference in outcome between the control and atorvastatin groups. The 5-year endpoint-free survival rate from study entry was 20%. Atorvastatin was withdrawn in 20% of patients due to unacceptable side-effects. In the atorvastatin group, low-density lipoprotein (LDL) cholesterol was reduced by 35% at 1 month and then sustained. The controls showed a progressive reduction in LDL cholesterol until 36 months.Although atorvastatin reduced total and LDL cholesterol effectively it was not beneficial regarding the long-term outcomes of cardiovascular endpoints or survival. In contrast to other patient groups, patients with severe chronic kidney disease, especially those on dialysis, seem to derive limited benefit from this lower dose of atorvastatin.
Databáze:	OpenAIRE
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