[Statins in patients with renal failure--the current therapeutic status].

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  • Author(s): Filipiak KJ;Filipiak KJ; Zawadzka-Byśko M
  • Source:
    Przeglad lekarski [Przegl Lek] 2005; Vol. 62 Suppl 2, pp. 51-4.
  • Publication Type:
    English Abstract; Journal Article; Review
  • Language:
    Polish
  • Additional Information
    • Transliterated Title:
      Statyny u chorych z niewydolnościa nerek--aktualne miejsce w terapii.
    • Source:
      Publisher: Wydawnicto Przeglad Lekarski Country of Publication: Poland NLM ID: 19840720R Publication Model: Print Cited Medium: Print ISSN: 0033-2240 (Print) Linking ISSN: 00332240 NLM ISO Abbreviation: Przegl Lek Subsets: MEDLINE
    • Publication Information:
      Original Publication: Kraków : Wydawnicto Przeglad Lekarski
    • Subject Terms:
      Hydroxymethylglutaryl-CoA Reductase Inhibitors/*therapeutic use ; Kidney Failure, Chronic/*drug therapy; Cytochrome P-450 CYP3A/metabolism ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects ; Rhabdomyolysis/chemically induced ; Rhabdomyolysis/epidemiology
    • Abstract:
      Statins are the most frequently used lipid-lowering drugs in all cardiovascular disease. It has been postulated that also patients with renal failure and end-stage renal disease (ESRD) may benefit from statin therapy. Moreover, statins may exhibit additional inhibitory effects on the atherogenesis, such as a modulation of the immune system as triggered by oxidatively modified LDL and a reduction of the inflammatory marker C-reactive protein (CRP). Statins reduce inflammation, cell proliferation, which leads to a reduction in cellular damage. Those effects are probably independent of cholesterol levels. Limited data suggest that HMG-CoA reductase inhibitors (statins) may slow loss of renal function in individuals with chronic renal insufficiency. It is concluded on the basis of the CARE trial that pravastatin may slow renal function loss in individuals with moderate to severe kidney disease, especially those with proteinuria. Similar data were obtained from recently published HPS trial with simvastatin. These findings require confirmation by a large randomized trial conducted specifically in people with chronic renal insufficiency. Statins vary in their pharmacological profiles, leading to distinct levels of systemic exposure and capacities to penetrate skeletal myocytes. Pharmacokinetic interactions with certain agents increase the likelihood of statin-induced myopathy and, in exceedingly rare instances, potentially fatal rhabdomyolysis with myoglobinuria and renal failure, therefore two statins have been suggested for renal failure patients. These are the ones that are not metabolised by the cytochrome P450 3A4 system--fluvastatin and pravastatin. The article summarizes the current therapeutic status of statin use in renal failure patients.
    • Number of References:
      30
    • Accession Number:
      0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
      EC 1.14.14.1 (Cytochrome P-450 CYP3A)
    • Publication Date:
      Date Created: 20060421 Date Completed: 20060712 Latest Revision: 20061115
    • Publication Date:
      20240829
    • Accession Number:
      16623120