Statins May Stave Off Kidney Problems In Patients With Heart Disease

Main Category: Heart Disease
Also Included In: Statins;  Urology / Nephrology
Article Date: 01 Jul 2004 - 15:00 PST

email to a friend   printer friendly   opinions  

Statins may stave off kidney problems in patients with heart disease, suggest the results of a long term trial in the Journal of Clinical Pathology.

Low levels of 'good' cholesterol (high density lipoprotein) and high levels of 'bad' cholesterol (low density lipoprotein) significantly increase the risk of heart disease. But a poor cholesterol profile also drives up the risk of kidney disease - itself a risk factor for coronary artery heart disease. Kidney function progressively declines as we age.

The findings are based on 1600 participants in the Greek atorvastatin and coronary heart disease evaluation (GREACE) study. All participants had established coronary heart disease, were under the age of 75, and had normally functioning kidneys at the start of the study.

Half were treated with atorvastatin, with two thirds taking 20 mg a day. The rest were given 'usual care,' which included a low fat diet, weight loss, and exercise. In this group, 113 patients also took some cholesterol lowering drugs.

For three years, the cholesterol profile and the creatine clearance of all participants were regularly assessed. Creatine clearance is a measure of how well the kidneys are working to clear waste (creatine) from the blood.

Creatine clearance fell by over 5% in those not treated with statins, and by just under 5% among the 17 patients who chose to discontinue treatment.

In those treated with statins, creatine clearance improved by 12% over the three years of the study, with the greatest improvement seen among those on higher doses and those whose kidney function was greater at the start of the study.

A total of 292 'events' occurred among the 1600 patients. One in four patients given usual care had a heart attack or stroke compared with 12% of patients given atorvastatin.

In patients given atorvastatin, cholesterol profile improved significantly, with the unfavourable to favourable cholesterol ratio halved compared with those given usual care.

Statin treatment cut the overall risk of death by 43%, and halved the risk of death from a heart attack. It also halved the risk of stroke.

The authors conclude that the significant increase in creatine clearance afforded by statin treatment helps to cut the risk of serious illness. Staving off poor kidney function could help to cut the risk profile for coronary artery disease, they suggest.

"Renal and coronary artery disease may progress in parallel," they say, with statins being good for both the heart and the kidneys.

[The effect of statins versus untreated dyslipidaemia on renal function in patients with coronary heart disease. A subgroup analysis of the Greek atorvastatin and coronary heart disease evaluation (GREACE) study J Clin Pathol 2004; 57: 728?734]

Contact:
Dr Vasilios Athyros, Atherosclerosis Unit, Aristotelian University,
Hippocration Hospital, Thessaloniki, Greece.
Tel: +30 2310 454 237 or 2310 892 606; Mobile: +30 6972 848 776
Email: athyros@med.auth.gr

Click here to view full paper:

Click here to view accompanying editorial: Embargo: 00:01 hrs UK time on Thursday 1 July 2004 For more information please contact: Emma Dickinson Tel: +44 (0)20 7383 6529 Fax: +44 (0)20 7383 6403 Email: edickinson@bmj.com. Public Affairs Division British Medical Association BMA House Tavistock Square London WC1H 9JP BMA Press Office telephones at ARM 01492 873 606 and 01492 873 607/608/609/610/611/612/613/614/615 Fax number: 01492 873 643 After 6.00 pm and weekends: +44 (0) 1923 350 436 +44 (0) 208 651 5130 +44 (0) 208 444 7992 +44 (0) 7870 477432 + 44 (0)115 845 1860

• Additional
• References
• Citations