Renoprotective effects of atorvastatin compared with pravastatin on progression of early diabetic nephropathy

Journal of Diabetes Investigation

Akiko Takazakura¹  Masaru Sakurai⁴  Yukihiro Bando²  Hirofumi Misu¹  Yumie Takeshita¹  Yuki Kita¹  Akiko Shimizu³  Tetsuo Hayakawa³  Ken-ichiro Kato¹  Shuichi Kaneko¹ 

[1] Department of Disease Control and Homeostasis, Kanazawa University Graduate School of Medical Sciences, Kanazawa, Japan;Department of Internal Medicine, Fukui-ken Saiseikai Hospital, Fukui, Fukui, Japan;Department of Internal Medicine, Toyama City Hospital, Toyama, Toyama, Japan;Department of Epidemiology and Public Health, Kanazawa Medical University, Uchinada, Ishikawa, Japan

关键词: Early diabetic nephropathy;    Renoprotective effects;    Statins;   

DOI  :  10.1111/jdi.12296

来源: Wiley

【 摘 要 】

Abstract

Introduction

Several studies have shown that statins suppress the progression of diabetic nephropathy. However, few reports have directly compared the renoprotective effects between potent and conventional statins.

Materials and Methods

Patients with diabetic nephropathy, selected as those with a serum creatinine level of 0.9–1.5 mg/dL and simultaneously having either microalbuminuria or positive proteinuria, were randomly assigned to one of three groups: a conventional diet therapy group, a group given 10 mg of pravastatin and a group given 10 mg of atorvastatin. Renal function was evaluated before and after a 12-month period of therapy.

Results

The atorvastatin group had a significant decrease in low-density lipoprotein cholesterol at 3 months and thereafter compared with the other groups. The urinary albumin-to-creatinine ratio significantly decreased in the atorvastatin group; the degree of this decrease was significantly greater than that in the diet therapy group. The kidney function estimated with cystatin C (CysC) and the estimated glomerular filtration rate calculated from CysC were significantly preserved in the atorvastatin group compared with the pravastatin group. In a multivariate regression analysis, the use of atorvastatin was the only explanatory variable for the changes in CysC; this was independent of changes in low-density lipoprotein cholesterol.

Conclusions

Atorvastatin is more effective than pravastatin for the prevention of increase in CysC, and this renoprotective effect was considered to a result of the pleiotropic effect of atorvastatin independent of its lipid-lowering effect. This study was registered with UMIN (no. UMIN 000001774).

【 授权许可】

CC BY-NC   
© 2014 The Authors. Journal of Diabetes Investigation published by Asian Association of the Study of Diabetes (AASD) and Wiley Publishing Asia Pty Ltd

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