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Nephrotic Syndrome and Statin Therapy: An Outcome Analysis

Background and Objectives: Hypercholesterolemia in patients with nephrotic syndrome (NS) may predispose to cardiovascular events and alter kidney function. We aimed to evaluate statins efficiency in NS patients under immunosuppression using four endpoints: remission rate (RR), end-stage kidney disea...

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Autores principales: Busuioc, Ruxandra, Ștefan, Gabriel, Stancu, Simona, Zugravu, Adrian, Mircescu, Gabriel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10054350/
https://www.ncbi.nlm.nih.gov/pubmed/36984513
http://dx.doi.org/10.3390/medicina59030512
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author Busuioc, Ruxandra
Ștefan, Gabriel
Stancu, Simona
Zugravu, Adrian
Mircescu, Gabriel
author_facet Busuioc, Ruxandra
Ștefan, Gabriel
Stancu, Simona
Zugravu, Adrian
Mircescu, Gabriel
author_sort Busuioc, Ruxandra
collection PubMed
description Background and Objectives: Hypercholesterolemia in patients with nephrotic syndrome (NS) may predispose to cardiovascular events and alter kidney function. We aimed to evaluate statins efficiency in NS patients under immunosuppression using four endpoints: remission rate (RR), end-stage kidney disease (ESKD), major cardiovascular events (MACE), and thrombotic complications (VTE). Materials and Methods: We retrospectively examined the outcome at 24 months after diagnosis of 154 NS patients (age 53 (39–64) years, 64% male, estimated glomerular filtration rate (eGFR) 61.9 (45.2–81.0) mL/min). During the follow-up, the lipid profile was evaluated at 6 months and at 1 and 2 years. Results: The median cholesterol level was 319 mg/dL, and 83% of the patients received statins. Patients without statins (17%) had similar age, body mass index, comorbidities, blood lipids levels, NS severity, and kidney function. The most used statin was simvastatin (41%), followed by rosuvastatin (32%) and atorvastatin (27%). Overall, 79% of the patients reached a form of remission, 5% reached ESKD, 8% suffered MACE, and 11% had VTE. The mean time to VTE was longer in the statin group (22.6 (95%CI 21.7, 23.6) versus 20.0 (95%CI 16.5, 23.5) months, p 0.02). In multivariate analysis, statin therapy was not associated with better RR, kidney survival, or fewer MACE; however, the rate of VTE was lower in patients on statins (HR 2.83 (95%CI 1.02, 7.84)). Conclusions: Statins did not improve the remission rate and did not reduce the risk of MACE or ESKD in non-diabetic nephrotic patients. However, statins seemed to reduce the risk of VTE. Further randomized controlled studies are needed to establish statins’ role in NS management.
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spelling pubmed-100543502023-03-30 Nephrotic Syndrome and Statin Therapy: An Outcome Analysis Busuioc, Ruxandra Ștefan, Gabriel Stancu, Simona Zugravu, Adrian Mircescu, Gabriel Medicina (Kaunas) Article Background and Objectives: Hypercholesterolemia in patients with nephrotic syndrome (NS) may predispose to cardiovascular events and alter kidney function. We aimed to evaluate statins efficiency in NS patients under immunosuppression using four endpoints: remission rate (RR), end-stage kidney disease (ESKD), major cardiovascular events (MACE), and thrombotic complications (VTE). Materials and Methods: We retrospectively examined the outcome at 24 months after diagnosis of 154 NS patients (age 53 (39–64) years, 64% male, estimated glomerular filtration rate (eGFR) 61.9 (45.2–81.0) mL/min). During the follow-up, the lipid profile was evaluated at 6 months and at 1 and 2 years. Results: The median cholesterol level was 319 mg/dL, and 83% of the patients received statins. Patients without statins (17%) had similar age, body mass index, comorbidities, blood lipids levels, NS severity, and kidney function. The most used statin was simvastatin (41%), followed by rosuvastatin (32%) and atorvastatin (27%). Overall, 79% of the patients reached a form of remission, 5% reached ESKD, 8% suffered MACE, and 11% had VTE. The mean time to VTE was longer in the statin group (22.6 (95%CI 21.7, 23.6) versus 20.0 (95%CI 16.5, 23.5) months, p 0.02). In multivariate analysis, statin therapy was not associated with better RR, kidney survival, or fewer MACE; however, the rate of VTE was lower in patients on statins (HR 2.83 (95%CI 1.02, 7.84)). Conclusions: Statins did not improve the remission rate and did not reduce the risk of MACE or ESKD in non-diabetic nephrotic patients. However, statins seemed to reduce the risk of VTE. Further randomized controlled studies are needed to establish statins’ role in NS management. MDPI 2023-03-06 /pmc/articles/PMC10054350/ /pubmed/36984513 http://dx.doi.org/10.3390/medicina59030512 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Busuioc, Ruxandra
Ștefan, Gabriel
Stancu, Simona
Zugravu, Adrian
Mircescu, Gabriel
Nephrotic Syndrome and Statin Therapy: An Outcome Analysis
title Nephrotic Syndrome and Statin Therapy: An Outcome Analysis
title_full Nephrotic Syndrome and Statin Therapy: An Outcome Analysis
title_fullStr Nephrotic Syndrome and Statin Therapy: An Outcome Analysis
title_full_unstemmed Nephrotic Syndrome and Statin Therapy: An Outcome Analysis
title_short Nephrotic Syndrome and Statin Therapy: An Outcome Analysis
title_sort nephrotic syndrome and statin therapy: an outcome analysis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10054350/
https://www.ncbi.nlm.nih.gov/pubmed/36984513
http://dx.doi.org/10.3390/medicina59030512
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