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Published in: Pediatric Nephrology 6/2009

01-06-2009 | Originals Article

Efficacy of simvastatin in children with hyperlipidemia secondary to kidney disorders

Authors: Silvestre García-de-la-Puente, José Luis Arredondo-García, Pedro Gutiérrez-Castrellón, Aurora Bojorquez-Ochoa, Edith Reyna Maya, María Del Pilar Pérez-Martínez

Published in: Pediatric Nephrology | Issue 6/2009

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Abstract

Children with hyperlipidemia secondary to renal disease develop premature atherosclerosis and glomerulosclerosis. The aims of this pilot study were to find the dosage and short-term efficacy of simvastatin and potential adverse events in children with chronic kidney diseases. This was a random, double-blind, placebo-controlled, cross-over clinical trial performed on children with hyperlipidemia secondary to kidney disorders. After being placed on a diet for 3 months, patients were randomly placed in one of two balanced group blocks and treated with diet plus placebo or simvastatin at doses of 5 mg for children weighing 30 kg or less and 10 mg for children weighing over 30 kg, for 1 month, and then doubled for two more months. After this treatment, patients were placed on a diet for a 3-month washout period. During the last trial phase, patients previously treated with simvastatin were administered a placebo, and vice versa. A total of 25 patients with ages ranging from 4 years to 17 years were included in the study. A significant decrease in the levels of serum cholesterol (26.4%), low-density lipoprotein (LDL) (35.4%) and triglycerides (23.1%) was noted during the study, primarily during the simvastatin treatments, in which case cholesterol, LDL and triglycerides decreased by 23.3%, 33.7% and 21%, respectively. High-density lipoprotein (HDL) levels increased moderately (10.7%) during the study but without differences during simvastatin treatment. No differences were found across groups with respect to adverse events. In the short-term the combination of diet and simvastatin was effective in lowering hyperlipidemia in children with renal disorders.
Literature
1.
go back to reference Tracy RE, Newman WP 3rd, Wattigney WA, Srinivasan SR, Strong JP, Berenson GS (1995) Histologic features of atherosclerosis and hypertension from autopsies of young individuals in a defined geographic population: the Bogalusa Heart Study. Atherosclerosis 116:163–179CrossRef Tracy RE, Newman WP 3rd, Wattigney WA, Srinivasan SR, Strong JP, Berenson GS (1995) Histologic features of atherosclerosis and hypertension from autopsies of young individuals in a defined geographic population: the Bogalusa Heart Study. Atherosclerosis 116:163–179CrossRef
2.
go back to reference Ross SD, Allen IE, Connelly JE, Korenblat BM, Smith ME, Bishop D, Luo D (1999) Clinical outcomes in statin treatment trials: a meta-analysis. Arch Intern Med 159:1793–1802CrossRef Ross SD, Allen IE, Connelly JE, Korenblat BM, Smith ME, Bishop D, Luo D (1999) Clinical outcomes in statin treatment trials: a meta-analysis. Arch Intern Med 159:1793–1802CrossRef
3.
go back to reference Kaysen GA (1991) Hyperlipidemia of the nephrotic syndrome. Kidney Int 39 [Suppl 31]:S8–S15 Kaysen GA (1991) Hyperlipidemia of the nephrotic syndrome. Kidney Int 39 [Suppl 31]:S8–S15
4.
go back to reference Joven J, Villabona C, Vilella E, Masana L, Albertí R, Vallés M (1990) Abnormalities of lipoprotein metabolism in patients with the nephrotic syndrome. N Engl J Med 323:579–584CrossRef Joven J, Villabona C, Vilella E, Masana L, Albertí R, Vallés M (1990) Abnormalities of lipoprotein metabolism in patients with the nephrotic syndrome. N Engl J Med 323:579–584CrossRef
5.
go back to reference Chan MK, Varghese Z, Moorhead JF (1981) Lipid abnormalities in uremia, dialysis and transplantation (review). Kidney Int 19:625–637CrossRef Chan MK, Varghese Z, Moorhead JF (1981) Lipid abnormalities in uremia, dialysis and transplantation (review). Kidney Int 19:625–637CrossRef
6.
go back to reference Querfeld U (1993) Disturbances of lipid metabolism in children with chronic renal failure. Pediatr Nephrol 7:749–757CrossRef Querfeld U (1993) Disturbances of lipid metabolism in children with chronic renal failure. Pediatr Nephrol 7:749–757CrossRef
7.
go back to reference Attman PO, Alaupovic P (1991) Lipid abnormalities in chronic renal insufficiency. Kidney Int 39 [Suppl 31]:S16–S23 Attman PO, Alaupovic P (1991) Lipid abnormalities in chronic renal insufficiency. Kidney Int 39 [Suppl 31]:S16–S23
8.
go back to reference Drueke TB, Abdulmassih Z, Lacour B, Bader C, Chevallier A, Kreis H (1991) Atherosclerosis and lipid disorders after renal transplantation. Kidney Int 39 [Suppl 31]:S24–S28 Drueke TB, Abdulmassih Z, Lacour B, Bader C, Chevallier A, Kreis H (1991) Atherosclerosis and lipid disorders after renal transplantation. Kidney Int 39 [Suppl 31]:S24–S28
9.
go back to reference Silverstein DM, Palmer J, Polinsky MS, Braas C, Conley SB, Baluarte HJ (2000) Risk factors for hyperlipidemia in long term pediatric renal transplant recipients. Pediatr Nephrol 14:105–110CrossRef Silverstein DM, Palmer J, Polinsky MS, Braas C, Conley SB, Baluarte HJ (2000) Risk factors for hyperlipidemia in long term pediatric renal transplant recipients. Pediatr Nephrol 14:105–110CrossRef
10.
go back to reference Aguilar-Salinas CA, Díaz-Polanco A, Quintana E, Macías N, Arellano A, Ramírez E, Ordóñez ML, Velásquez-Alva C, Gómez Pérez FJ, Alberú J, Correa-Rotter R (2002) Genetic factors play an important role in the pathogenesis of hyperlipidemia post-transplantation. Am J Kidney Dis 40:169–177CrossRef Aguilar-Salinas CA, Díaz-Polanco A, Quintana E, Macías N, Arellano A, Ramírez E, Ordóñez ML, Velásquez-Alva C, Gómez Pérez FJ, Alberú J, Correa-Rotter R (2002) Genetic factors play an important role in the pathogenesis of hyperlipidemia post-transplantation. Am J Kidney Dis 40:169–177CrossRef
11.
go back to reference Duplaga BA (1999) Treatment of childhood hypercholesterolemia with HMG-CoA reductase inhibitors. Ann Pharmacother 33:1224–1227CrossRef Duplaga BA (1999) Treatment of childhood hypercholesterolemia with HMG-CoA reductase inhibitors. Ann Pharmacother 33:1224–1227CrossRef
12.
go back to reference Avis HJ, Vissers MN, Stein EA, Wijburg FA, Trip MD, Kastelein JJ, Hutten BA (2007) A systematic review and meta-analysis of statin therapy in children with familial hypercholesterolemia. Arterioscler Thromb Vasc Biol 27:1803–1810CrossRef Avis HJ, Vissers MN, Stein EA, Wijburg FA, Trip MD, Kastelein JJ, Hutten BA (2007) A systematic review and meta-analysis of statin therapy in children with familial hypercholesterolemia. Arterioscler Thromb Vasc Biol 27:1803–1810CrossRef
13.
go back to reference Massy ZA, Luois TA, Kasike BL (1995) Lipid-lowering therapy in patients with renal disease. Kidney Int 48:188–198CrossRef Massy ZA, Luois TA, Kasike BL (1995) Lipid-lowering therapy in patients with renal disease. Kidney Int 48:188–198CrossRef
14.
go back to reference Vrecer M, Turk S, Drinovec J, Mrhar A (2003) Use of statins in primary and secondary prevention of coronary heart disease and ischemic stroke. Meta-analysis of randomized trials. Int J Clin Pharmacol Ther 41:567–577CrossRef Vrecer M, Turk S, Drinovec J, Mrhar A (2003) Use of statins in primary and secondary prevention of coronary heart disease and ischemic stroke. Meta-analysis of randomized trials. Int J Clin Pharmacol Ther 41:567–577CrossRef
15.
go back to reference Henyan NN, Riche DM, East HE, Gann PN (2007) Impact of statins on risk of stroke: a meta-analysis. Ann Pharmacother 41:1937–1945CrossRef Henyan NN, Riche DM, East HE, Gann PN (2007) Impact of statins on risk of stroke: a meta-analysis. Ann Pharmacother 41:1937–1945CrossRef
16.
go back to reference Holdaas H, Wanner C, Abletshauser C, Gimpelewicz C, Isaacsohn J (2007) The effect of fluvastatin on cardiac outcomes in patients with moderate to severe renal insufficiency: a pooled analysis of double-blind, randomized trials. Int J Cardiol 117:64–74CrossRef Holdaas H, Wanner C, Abletshauser C, Gimpelewicz C, Isaacsohn J (2007) The effect of fluvastatin on cardiac outcomes in patients with moderate to severe renal insufficiency: a pooled analysis of double-blind, randomized trials. Int J Cardiol 117:64–74CrossRef
17.
go back to reference Rodenburg J, Vissers MN, Wiegman A, van Trotsenburg AS, van der Graaf A, de Groot E, Wijburg FA, Kastelein JJ, Hutten BA (2007) Statin treatment in children with familial hypercholesterolemia: the younger, the better. Circulation 116:664–668CrossRef Rodenburg J, Vissers MN, Wiegman A, van Trotsenburg AS, van der Graaf A, de Groot E, Wijburg FA, Kastelein JJ, Hutten BA (2007) Statin treatment in children with familial hypercholesterolemia: the younger, the better. Circulation 116:664–668CrossRef
18.
go back to reference Coleman JE, Watson AR (1996) Hyperlipidaemia, diet and simvastatin therapy in steroid-resistant nephrotic syndrome of childhood. Pediatr Nephrol 10:171–174CrossRef Coleman JE, Watson AR (1996) Hyperlipidaemia, diet and simvastatin therapy in steroid-resistant nephrotic syndrome of childhood. Pediatr Nephrol 10:171–174CrossRef
19.
go back to reference Sanjad SA, Al-Abbad A, Al-Hhorafa S (1997) Management of hyperlipidemia in children with refractory nephrotic syndrome: the effect of statin therapy. J Pediatr 130:470–474CrossRef Sanjad SA, Al-Abbad A, Al-Hhorafa S (1997) Management of hyperlipidemia in children with refractory nephrotic syndrome: the effect of statin therapy. J Pediatr 130:470–474CrossRef
20.
go back to reference Edwards JE, Moore RA (2003) Statins in hypercholesterolaemia: A dose-specific meta- analysis of lipid changes in randomized, double blind trials. BMC Fam Pract 4:18CrossRef Edwards JE, Moore RA (2003) Statins in hypercholesterolaemia: A dose-specific meta- analysis of lipid changes in randomized, double blind trials. BMC Fam Pract 4:18CrossRef
21.
go back to reference Law M, Rudnicka AR (2006) Statin safety: a systematic review. Am J Cardiol 97:52C–60CCrossRef Law M, Rudnicka AR (2006) Statin safety: a systematic review. Am J Cardiol 97:52C–60CCrossRef
Metadata
Title
Efficacy of simvastatin in children with hyperlipidemia secondary to kidney disorders
Authors
Silvestre García-de-la-Puente
José Luis Arredondo-García
Pedro Gutiérrez-Castrellón
Aurora Bojorquez-Ochoa
Edith Reyna Maya
María Del Pilar Pérez-Martínez
Publication date
01-06-2009
Publisher
Springer Berlin Heidelberg
Published in
Pediatric Nephrology / Issue 6/2009
Print ISSN: 0931-041X
Electronic ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-009-1128-7

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