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Should we use statins in all patients with chronic kidney disease without dialysis therapy? The current state of knowledge

International Urology and Nephrology volume 47, pages 805–813 (2015)Cite this article

Abstract

Purpose

The aim of this article was to present the most important matters associated with dyslipidemia treatment in CKD patients. Moreover, the most important recommendations of the current (2013) KDIGO clinical practice guideline for lipid management in chronic kidney disease are presented.

Methods

Authors looked through the most recent large clinical trials and meta-analyses and presented their results. We searched using the electronic databases [MEDLINE, EMBASE, Scopus, DARE]. Additionally, abstracts from national and international cardiovascular meetings were studied.

Results

Analysis results suggest that statins exert beneficial effects on kidney since they considerably reduce 24 h urinary protein excretion and are associated with a rise in GFR. Beneficial effects of statins may be influenced by kidney disease stage, doses of medicine and treatment duration. Data suggest that statins are effective and safe for secondary prevention of CV events in individuals with mild CKD. Patients treated with statins had decreased frequency of major atherosclerotic events compared with placebo, reduced risk of CV mortality and deaths from all causes.

Conclusions

Meta-analyses results suggest that statins are associated with lipid lowering, cardiovascular and anti-proteinuric benefits in CKD patients. However, their effects on overall and cardiovascular mortality are much less obvious. Bearing in mind the advantageous effects and low risk of adverse effects, it seems that mild renal impairment should not exclude these patients from receiving a statin. However, because CKD patients in stages III–V are underrepresented in clinical trials, administration of statins to these patients who have not yet had a vascular event remains controversial.

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Affiliations

  1. Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital of Lodz, Zeromskiego 113, 90-549, Lodz, Poland

    Jacek Rysz & Anna Gluba-Brzózka

  2. Department of Hypertension, Medical University of Lodz, Lodz, Poland

    Maciej Banach

  3. Department of Nephrology, Endocrinology and Metabolic Diseases, Medical University of Silesia, Katowice, Poland

    Andrzej Więcek

  4. Healthy Aging Research Center, Medical University of Lodz, Lodz, Poland

    Jacek Rysz, Anna Gluba-Brzózka & Maciej Banach

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  1. Jacek Rysz
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  2. Anna Gluba-Brzózka
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  4. Andrzej Więcek
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Correspondence to Anna Gluba-Brzózka.

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Rysz, J., Gluba-Brzózka, A., Banach, M. et al. Should we use statins in all patients with chronic kidney disease without dialysis therapy? The current state of knowledge. Int Urol Nephrol 47, 805–813 (2015). https://doi.org/10.1007/s11255-015-0937-9

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Keywords

  • Chronic kidney disease
  • Dyslipidemia
  • Statins
  • Recommendations
  • Guidelines