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Atherosclerosis. 2010 Nov;213(1):218-24. doi: 10.1016/j.atherosclerosis.2010.07.053. Epub 2010 Aug 11.

Effect of atorvastatin on kidney function in chronic kidney disease: a randomised double-blind placebo-controlled trial.

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1
Renal Medicine, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. r.fassett@uq.edu.au

Abstract

BACKGROUND:

The effect of atorvastatin on kidney function was assessed in patients with stages 2-4 chronic kidney disease.

METHODS:

We conducted a randomised, double-blind, placebo-controlled trial in chronic kidney disease clinics in Northern Tasmania and enrolled 132 patients with serum creatinine levels >120 μmol/l, not taking lipid-lowering therapy and at all levels of proteinuria and serum cholesterol. Patients were randomly assigned to receive either 10 mg of atorvastatin/day (64) or placebo (68) and were followed with trial visits 3-monthly for a mean of 2.5 yrs. The primary outcome was the rate of both MDRD eGFR and Cockcroft-Gault creatinine clearance (C-G CrCl) decline. Analysis was based on intention to treat and included all patients that had at least one follow-up visit.

RESULTS:

The rate of MDRD eGFR decline was 29% lower; 1.04 ± 3.84 vs. 1.47 ± 3.74 ml/min/1.73 m(2)/yr (P=0.53), and the C-G CrCl was 20% lower; 1.88 ± 5.07 vs. 2.36 ± 4.61 ml/min/1.73 m(2)/yr (P=0.58) in atorvastatin-treated, compared with placebo-treated patients. Although blood pressure decreased in both atorvastatin and placebo-treated groups there were no differences between groups. In addition, there was no difference in concomitant medication intake including angiotensin converting enzyme inhibitors and angiotensin receptor blockers between groups.

CONCLUSIONS:

There was a trend toward a slower eGFR decline in the atorvastatin-treated group that did not reach statistical significance. This may have been due to the lack of power of the study. However, atorvastatin may have a renoprotective effect in those patients with chronic kidney disease and cardiovascular disease. This needs to be assessed in further studies.

[Indexed for MEDLINE]

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