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

• Published in: Endocrine Journal Vol. 58; no. 8; pp. 663 - 674
• Main Authors: Abe, Masanori, Maruyama, Noriaki, Yoshida, Yoshinori, Ito, Midori, Okada, Kazuyoshi, Soma, Masayoshi
• Format: Journal Article
• Language: English
• Published: Japan The Japan Endocrine Society 2011
• Subjects: Aged; Albuminuria; Blood Glucose - drug effects; Blood Glucose - physiology; Blood Pressure - drug effects; Blood Pressure - physiology; Chronic kidney disease; Cystatin C; 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; Malondialdehyde-modified LDL (MDA-LDL); Middle Aged; Pyrimidines - adverse effects; Pyrimidines - pharmacology; Pyrimidines - therapeutic use; Rosuvastatin; Rosuvastatin Calcium; Sulfonamides - adverse effects; Sulfonamides - pharmacology; Sulfonamides - therapeutic use; Treatment Outcome
• ISSN: 0918-8959; 1348-4540
• DOI: 10.1507/endocrj.K11E-080

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 m2 or more, normal-GFR group; less than 60 mL/min/1.73 m2, 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.