Statins Reduce Progression of Kidney Function Decline in Chronic Kidney Disease

Progression of kidney function decline and proteinuria in patients with and without chronic kidney disease (CKD) is significantly mitigated with statin use. These findings were presented at the National Lipid Association (NLA) Scientific Sessions 2023, held in Atlanta, Georgia, between June 1 and June 4, 2023.

Investigators sought to assess the efficacy and safety of statin therapy in individuals with and without baseline kidney disease. Secondary endpoints included evaluation of changes in estimated glomerular filtration rate (eGFR) and proteinuria, and beneficial effects of statins on low-density lipoprotein cholesterol (LDL-C) concentrations.

The investigators conducted a pair-wise random effects meta-analysis including articles from Cochrane, PubMed, and Embase from inception to October 2022. They found 48 studies (33 used hydrophobic statins; 15 used hydrophilic statins) that included 6668 individuals with CKD at baseline (mean age, 58±9.3 years; mean eGFR in statin group 68±31mL/min/m² vs mean eGFR in placebo group 70±30.8mL/min/m²). There were 45 studies evaluating baseline and post-treatment eGFR and 16 studies examining proteinuria changes.

Investigators found the statin group vs placebo group showed significant improvement in eGFR (mean difference [MD], 0.067; 95% CI, 0.055-0.079; P ≤.00001), significant reduction in proteinuria (MD, -0.643; 95% CI, -1.002 to -0.285; P ≤.00001), and significant reduction in LDL-C (statin group, 143±32mg/dL to 100±21; vs placebo group 141±39 mg/dL to 140±42).

“Statin use significantly attenuated the progression of kidney function decline and proteinuria,” the investigators wrote. Statin type and baseline CKD status may alter the renoprotective effect of a statin. They added, “These results should spur RCTs [randomized controlled trials] that use CKD progression as one of the primary endpoints in patients with CKD and ASCVD, which will inform future guidelines about the potential for statin use in preventing CKD progression while also reducing major adverse cardiac events.”