Skip to main content
Top
Published in: Clinical and Experimental Nephrology 2/2014

01-04-2014 | Review Article

Statins in chronic kidney disease: what do meta-analyses tell us?

Author: Ashish Upadhyay

Published in: Clinical and Experimental Nephrology | Issue 2/2014

Login to get access

Abstract

Dyslipidemia is common in patients with chronic kidney disease (CKD), and previous reports indicate that a significant number of CKD patients with dyslipidemia do not receive statin therapy. This article reviews two recent meta-analyses on statin therapy in CKD which summarize results from randomized controlled trials that have reported on hard clinical outcomes and major adverse events. Despite differences in methodology, both meta-analyses show that statin therapy is safe and effective in preventing mortality and major cardiovascular events in non-dialysis-dependent CKD patients. However, there is very limited evidence to support the use of statins in patients on dialysis, and statin therapy was not found to be effective in reducing the risk of kidney failure or decline in kidney function.
Literature
1.
go back to reference Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305.PubMedCrossRef Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med. 2004;351:1296–305.PubMedCrossRef
2.
go back to reference Kasiske BL. Hyperlipidemia in patients with chronic renal disease. Am J Kidney Dis. 1998;32(Suppl 3):S142–56.PubMedCrossRef Kasiske BL. Hyperlipidemia in patients with chronic renal disease. Am J Kidney Dis. 1998;32(Suppl 3):S142–56.PubMedCrossRef
3.
go back to reference Tonelli M, Muntner P, Lloyd A, Manns BJ, Klarenbach S, Pannu N, et al. Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet. 2012;380:807–14.PubMedCrossRef Tonelli M, Muntner P, Lloyd A, Manns BJ, Klarenbach S, Pannu N, et al. Risk of coronary events in people with chronic kidney disease compared with those with diabetes: a population-level cohort study. Lancet. 2012;380:807–14.PubMedCrossRef
4.
go back to reference Kidney Disease Outcomes Quality Initiative (K/DOQI) Group. K/DOQI clinical practice guidelines for managing dyslipidemias in chronic kidney disease. Am J Kidney Dis. 2003;41(Suppl 3):S1–77. Kidney Disease Outcomes Quality Initiative (K/DOQI) Group. K/DOQI clinical practice guidelines for managing dyslipidemias in chronic kidney disease. Am J Kidney Dis. 2003;41(Suppl 3):S1–77.
5.
go back to reference Levey AS, Beto JA, Coronado BE, Eknoyan G, Foley RN, Kasiske BL, et al. Controlling the epidemic of cardiovascular disease in chronic renal disease: what do we know? What do we need to learn? Where do we go from here? National Kidney Foundation Task Force on cardiovascular disease. Am J Kidney Dis. 1998;32:853–906.PubMedCrossRef Levey AS, Beto JA, Coronado BE, Eknoyan G, Foley RN, Kasiske BL, et al. Controlling the epidemic of cardiovascular disease in chronic renal disease: what do we know? What do we need to learn? Where do we go from here? National Kidney Foundation Task Force on cardiovascular disease. Am J Kidney Dis. 1998;32:853–906.PubMedCrossRef
6.
go back to reference Parikh NI, Hwang SJ, Larson MG, Meigs JB, Levy D, Fox CS. Cardiovascular disease risk factors in chronic kidney disease: overall burden and rates of treatment and control. Arch Intern Med. 2006;166:1884–91.PubMedCrossRef Parikh NI, Hwang SJ, Larson MG, Meigs JB, Levy D, Fox CS. Cardiovascular disease risk factors in chronic kidney disease: overall burden and rates of treatment and control. Arch Intern Med. 2006;166:1884–91.PubMedCrossRef
7.
go back to reference Tonelli M, Bohm C, Pandeya S, Gill J, Levin A, Kiberd BA. Cardiac risk factors and the use of cardioprotective medications in patients with chronic renal insufficiency. Am J Kidney Dis. 2001;37:484–9.PubMedCrossRef Tonelli M, Bohm C, Pandeya S, Gill J, Levin A, Kiberd BA. Cardiac risk factors and the use of cardioprotective medications in patients with chronic renal insufficiency. Am J Kidney Dis. 2001;37:484–9.PubMedCrossRef
8.
go back to reference Upadhyay A, Earley A, Lamont JL, Haynes S, Wanner C, Balk EM. Lipid-lowering therapy in persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med. 2012;157:251–62.PubMedCrossRef Upadhyay A, Earley A, Lamont JL, Haynes S, Wanner C, Balk EM. Lipid-lowering therapy in persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med. 2012;157:251–62.PubMedCrossRef
9.
go back to reference Palmer SC, Craig JC, Navaneethan SD, Tonelli M, Pellegrini F, Strippoli GF. Benefits and harms of statin therapy for persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med. 2012;157:263–75.PubMedCentralPubMedCrossRef Palmer SC, Craig JC, Navaneethan SD, Tonelli M, Pellegrini F, Strippoli GF. Benefits and harms of statin therapy for persons with chronic kidney disease: a systematic review and meta-analysis. Ann Intern Med. 2012;157:263–75.PubMedCentralPubMedCrossRef
10.
go back to reference Strippoli GF, Navaneethan SD, Johnson DW, Perkovic V, Pellegrini F, Nicolucci A, et al. Effects of statins in patients with chronic kidney disease: meta-analysis and meta-regression of randomised controlled trials. BMJ. 2008;336:645–51.PubMedCentralPubMedCrossRef Strippoli GF, Navaneethan SD, Johnson DW, Perkovic V, Pellegrini F, Nicolucci A, et al. Effects of statins in patients with chronic kidney disease: meta-analysis and meta-regression of randomised controlled trials. BMJ. 2008;336:645–51.PubMedCentralPubMedCrossRef
11.
go back to reference Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490.PubMedCrossRef Atkins D, Best D, Briss PA, Eccles M, Falck-Ytter Y, Flottorp S, et al. Grading quality of evidence and strength of recommendations. BMJ. 2004;328:1490.PubMedCrossRef
12.
go back to reference Uhlig K, Macleod A, Craig J, Lau J, Levey AS, Levin A, et al. Grading evidence and recommendations for clinical practice guidelines in nephrology. A position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int. 2006;70:2058–65.PubMed Uhlig K, Macleod A, Craig J, Lau J, Levey AS, Levin A, et al. Grading evidence and recommendations for clinical practice guidelines in nephrology. A position statement from kidney disease: improving global outcomes (KDIGO). Kidney Int. 2006;70:2058–65.PubMed
13.
go back to reference Kasiske BL, Wheeler DC. The management of dyslipidemia in CKD: new analyses of an expanding dataset. Am J Kidney Dis. 2013;61:371–4.PubMedCrossRef Kasiske BL, Wheeler DC. The management of dyslipidemia in CKD: new analyses of an expanding dataset. Am J Kidney Dis. 2013;61:371–4.PubMedCrossRef
14.
go back to reference Massy ZA, de Zeeuw D. LDL cholesterol in CKD––to treat or not to treat? Kidney Int. 2013;84:451–6.PubMedCrossRef Massy ZA, de Zeeuw D. LDL cholesterol in CKD––to treat or not to treat? Kidney Int. 2013;84:451–6.PubMedCrossRef
Metadata
Title
Statins in chronic kidney disease: what do meta-analyses tell us?
Author
Ashish Upadhyay
Publication date
01-04-2014
Publisher
Springer Japan
Published in
Clinical and Experimental Nephrology / Issue 2/2014
Print ISSN: 1342-1751
Electronic ISSN: 1437-7799
DOI
https://doi.org/10.1007/s10157-013-0889-2

Other articles of this Issue 2/2014

Clinical and Experimental Nephrology 2/2014 Go to the issue