SAFETY AND EFFICACY OF ROSUVASTATIN FOR HYPERLIPIDEMIA IN PATIENTS WITH CHRONIC KIDNEY DISEASE (CKD) STAGE 3 AND ABOVE

• Main Authors: Jun Yuto, Yosuke Ehara, Kazuhiko Shibata, Tamio Iwamoto, Gen Yasuda, Mari Katsumata, Yuichiro Yamamoto, Nobuhito Hirawa
• Format: Article
• Language: English
• Published: The Korean Society of Nephrology 2012-06-01
• Series: Kidney Research and Clinical Practice
• Online Access: http://www.sciencedirect.com/science/article/pii/S2211913212006328

The frequency of hypertriglyceridemia is high in CKD patients, but few medications are available for controlling this lipid parameter when renal insufficiency advances. We evaluated the safety and efficacy of long-term treatment with rosuvastatin, one of the strong statins for hypercholesterolemic control, on lipid abnormalities in patients with CKD stage 3 and above. The protocol consisted of a 4-week run-in period and a 48-week treatment phase with rosuvastatin. Inclusion criteria were CKD stage 3 and above with serum low-density lipoprotein (LDL) cholesterol levels above 100 mg/dL and triglyceride levels above 150 mg/dL. Patients received 2.5 to 5.0 mg rosuvastatin daily. Lipid parameters and myolysis-related indicators were measured. Forty-nine patients (29 men and 20 women aged 61 ± 9 years, serum creatinine levels above 1.5 mg/dL) were enrolled in the study. Rosuvastatin significantly decreased (P〈0.05) serum LDL cholesterol from 163 ± 39 to 126 ± 31 mg/dL and apolipoprotein B from 151 ± 36 to 108 ± 24 mg/dL at 4 weeks and maintained these parameters at low levels. Rosuvastatin also significantly decreased (P = 0.001) serum triglyceride levels from 194 ± 43 mg/dL at baseline to 160 ± 51 mg/dL at 48 weeks. High-density lipoprotein (HDL) cholesterol concentrations did not change from baseline (56 ± 16 mg/dL) to 48 weeks of treatment (57 ± 17 mg/dL). However, LDL/HDL ratio decreased significantly (P = 0.036) from 3.4 ± 0.7 to 2.2 ± 0.9, which approached the target level (2.0). During the rosuvastatin treatment period, serum creatine kinase, aldolase, and myoglobin concentrations did not change. In conclusion, rosuvastatin treatment improved serum triglyceride level as well as the LDL/HDL ratio in hyperlipidemic patients with CKD stage 3 and above, without serious adverse effects, suggesting that rosuvastatin is useful to control not only hypercholesterolemia but also hypertriglyceridemia in CKD patients.