Meta-analysis of the impact of statins on change in renal function in patients with moderate or severe chronic kidney disease
Vedamurthy D, Sagheer U, Tyagi M, Maki KC, Kalra DK
Journal of clinical lipidology · 1 cita
Etiquetas de revisión
Financiación no declaradaDatos neutrales que nuestra revisión registró sobre cómo se hizo este estudio. Describen el método, nunca si nos gusta el resultado.
Cómo se estudió
- Diseño
- Metaanálisis (indexado por PubMed)
- Estudiado en
- Personas
- Resultado principal
- Marcadores de salud y funcionamiento
Quién lo pagó
- Financiación
- Financiación no declarada
Publicación
- Publicado
- 2025-09-17 · J Clin Lipidol · vol. 19 · número 6 · págs. 1575–1585
- Editorial
- Elsevier BV
- Citado
- 4 citas · más que el 73% de estudios similares · 0.9× el promedio de su campo
- Referencias
- 52 trabajos
- Acceso
- De pago
- Áreas de investigación
- Chronic Kidney Disease and Diabetes · Lipoproteins and Cardiovascular Health · Acute Kidney Injury Research
- Palabras clave
- statins, chronic kidney disease, estimated glomerular filtration rate decline, renal function, atherosclerotic cardiovascular disease, primary prevention, secondary prevention, LDL cholesterol, cardiovascular risk
- MeSH
- kidney, humans, hydroxymethylglutaryl-coa reductase inhibitors, glomerular filtration rate, renal insufficiency, chronic, randomized controlled trials as topic
5 autores
- Deepak Vedamurthy🇺🇸University of Louisville
- Usman Sagheer🇺🇸University of Louisville
- Mahima Tyagi🇺🇸University of Louisville
- Kevin Carl Maki🇺🇸Indiana University Bloomington; Indiana University
- Dinesh K. Kalra🇺🇸 · autor de correspondenciaUniversity of Louisville
Resumen
El texto original del estudio, en el idioma en que se publicó.
Objective
Chronic kidney disease (CKD) patients have an elevated risk of atherosclerotic cardiovascular disease (ASCVD)-statins remain the cornerstone in reducing this increased risk. In prior analyses, statins have been suggested to have a benefit in slowing the decline in renal function over time in mild CKD (ie, stage 1 or 2 CKD, or estimated glomerular filtration rate [eGFR] ≥ 60 mL/min/1.73 m2). Whether these benefits also extend to patients with moderate or severe (ie, stages 3 or 4, or eGFR 15-59 mL/min/1.73 m2) CKD is unknown.
Methods
We performed a meta-analysis to study the effect of statins on the eGFR in patients with stage 3 or 4 CKD. Thirteen randomized controlled trials that included 14,393 patients were included. Six of these studies evaluated statins in primary ASCVD prevention, 6 evaluated statins in secondary prevention, and 1 included both. Follow-up ranged from 12 months to 6 years. The mean eGFR at baseline in the statin and nonstatin groups was 49.03 ± 9.7 and 52.81 ± 9.8 mL/min/1.73 m2, respectively.
Results
Compared to controls, the statin group had a slower rate of eGFR decline (difference between the groups = 0.26 mL/min/1.73 m2/y [95% CI: 0.10-0.42; P = .0017]). Meta-regression showed that, except for baseline low-density lipoprotein cholesterol, moderators such as age, diabetes, or hypertension did not explain the residual heterogeneity. Egger's test showed no statistically significant evidence of publication bias (P = .13).
Conclusion
In patients with stage 3 or 4 CKD, compared to placebo, statins slowed the decline in renal function over time, in both primary and secondary prevention patients. Thus, statins can not only reduce adverse cardiovascular outcomes in this patient population but also potentially reduce the loss of renal function.
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