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

Intern Med. 2008;47(17):1505-10. doi: 10.2169/internalmedicine.47.1159. Epub 2008 Sep 1.

Abstract

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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Atherosclerosis / complications
  • Atherosclerosis / drug therapy*
  • Atherosclerosis / pathology*
  • Cholesterol, LDL / blood
  • Female
  • Fluorobenzenes / pharmacology
  • Fluorobenzenes / therapeutic use*
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Hypercholesterolemia / blood
  • Hypercholesterolemia / drug therapy
  • Hypercholesterolemia / pathology
  • Kidney Failure, Chronic / complications
  • Kidney Failure, Chronic / drug therapy*
  • Kidney Failure, Chronic / pathology*
  • Male
  • Middle Aged
  • Prospective Studies
  • Pyrimidines / pharmacology
  • Pyrimidines / therapeutic use*
  • Rosuvastatin Calcium
  • Sulfonamides / pharmacology
  • Sulfonamides / therapeutic use*
  • Tunica Intima / drug effects
  • Tunica Intima / pathology

Substances

  • Cholesterol, LDL
  • Fluorobenzenes
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Pyrimidines
  • Sulfonamides
  • Rosuvastatin Calcium