Effect of atorvastatin on kidney function in chronic kidney disease: A randomised double-blind placebo-controlled trial

Fassett, Robert G.; Robertson, Iain K.; Ball, Madeleine J.; Geraghty, Dominic P.; Coombes, Jeff S.

doi:10.1016/j.atherosclerosis.2010.07.053

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Volume 213, Issue 1 , Pages 218-224, November 2010

Effect of atorvastatin on kidney function in chronic kidney disease: A randomised double-blind placebo-controlled trial☆

Robert G. Fassett
- Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Clifford Craig Medical Research Trust, Launceston, Tasmania, Australia
- School of Human Life Sciences, University of Tasmania, Launceston, Tasmania, Australia
- School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia
- School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Corresponding author at: Renal Medicine, Level 9, Ned Hanlon Building, Royal Brisbane and Women's Hospital, Butterfield Street, Brisbane, Queensland 4029, Australia. Tel.: +61 419399571; fax: +61 736368572.
Iain K. Robertson
- Clifford Craig Medical Research Trust, Launceston, Tasmania, Australia
- School of Human Life Sciences, University of Tasmania, Launceston, Tasmania, Australia
Madeleine J. Ball
- School of Human Life Sciences, University of Tasmania, Launceston, Tasmania, Australia
Dominic P. Geraghty
- School of Human Life Sciences, University of Tasmania, Launceston, Tasmania, Australia
Jeff S. Coombes
- School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia

Received 5 May 2010; received in revised form 25 July 2010; accepted 28 July 2010. published online 01 September 2010.

Abstract

Background

The effect of atorvastatin on kidney function was assessed in patients with stages 2–4 chronic kidney disease.

Methods

We conducted a randomised, double-blind, placebo-controlled trial in chronic kidney disease clinics in Northern Tasmania and enrolled 132 patients with serum creatinine levels >120μmol/l, not taking lipid-lowering therapy and at all levels of proteinuria and serum cholesterol. Patients were randomly assigned to receive either 10mg of atorvastatin/day (64) or placebo (68) and were followed with trial visits 3-monthly for a mean of 2.5 yrs. The primary outcome was the rate of both MDRD eGFR and Cockcroft–Gault creatinine clearance (C–G CrCl) decline. Analysis was based on intention to treat and included all patients that had at least one follow-up visit.

Results

The rate of MDRD eGFR decline was 29% lower; 1.04±3.84 vs. 1.47±3.74ml/min/1.73m²/yr (P=0.53), and the C–G CrCl was 20% lower; 1.88±5.07 vs. 2.36±4.61ml/min/1.73m²/yr (P=0.58) in atorvastatin-treated, compared with placebo-treated patients. Although blood pressure decreased in both atorvastatin and placebo-treated groups there were no differences between groups. In addition, there was no difference in concomitant medication intake including angiotensin converting enzyme inhibitors and angiotensin receptor blockers between groups.

Conclusions

There was a trend toward a slower eGFR decline in the atorvastatin-treated group that did not reach statistical significance. This may have been due to the lack of power of the study. However, atorvastatin may have a renoprotective effect in those patients with chronic kidney disease and cardiovascular disease. This needs to be assessed in further studies.

Keywords: Statins, Chronic kidney disease, Glomerular filtration rate, Proteinuria