Statins and kidney disease: is the study of heart and renal protection at the cutting edge of evidence?
Current Opinion in Cardiology, 06/28/2012
Jenkins M et al. – The evidence that statins have a cardiovascular and mortality benefit in CKD stages I–IV has been reinforced by SHARP, which also definitively shows that there are no special safety concerns for their administration in CKD. However, the utility of the use of statins in patients on dialysis is far from clear, at least in the opinion. The effect of statins on renal outcomes is unconvincing and the evidence does not presently support their use for these indications alone.
- The Study of Heart and Renal Protection (SHARP) trial published in June 2011 was the first trial specifically powered to investigate atherosclerotic outcomes in CKD patients.
- It found a 17% overall reduction in major adverse cardiac events in the statin–treated group compared with placebo, yet no effect on any renal outcomes of proteinuria and progressive decline of glomerular filtration rate.
- Furthermore, the Swedish Web–system for Enhancement and Development of Evidencebased care in Heart disease Evaluated According to Recommended Therapies (SWEDEHEART) investigators provided further important observational data on the beneficial effect of statins in CKD stages I–IV.