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Statins for dialysis patients

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Statins for dialysis patients

Sübutlu məlumatların xülasələri
26.06.2017 • Sonuncu dəyişiklik 26.06.2017
Editors

Statins do not decrease mortality or cardiovascular events compared to placebo, even though they appear to decrease serum cholesterol levels in dialysis patients.

A Cochrane review included 25 studies with a total of 8 289 subjects. 23 studies compared statins with placebo or no treatment and 2 studies compared statins directly with one or more other statins in dialysis patients. Compared to placebo, statins did not decrease all-cause mortality (RR 0.96, 95% CI 0.90 to 1.02; 13 studies, n=4705) or cardiovascular mortality (RR 0.94, 95% CI 0.84 to 1.06; 13 studies, n=4627), or major cardiovascular events (RR 0.95, 95% CI 0.88 to 1.03; 4 studies, n=7084).

Compared with placebo, statins reduced total cholesterol (MD -44.86 mg/dL (1.14 mmol/L), 95% CI -55.19 to -34.53; 14 studies, n=1803, LDL cholesterol (MD -39.99 mg/d (1.01mmol/L), 95% CI -52.46 to -27.52; 2 studies, n=1747.

Risks of adverse events from statin therapy were uncertain; these included effects on elevated creatine kinase (5 studies, 3067 participants: RR 1.25, 95% CI 0.55 to 2.83) or liver function enzymes (4 studies, 3044 participants; RR 1.09, 95% CI 0.41 to 1.25), withdrawal due to adverse events (9 studies, 1832 participants: RR 1.04, 95% CI 0.87 to 1.25) .

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment, lack of blinding and inadequate intention-to-treat adherence).

Ədəbiyyat

  1. Navaneethan SD, Nigwekar SU, Perkovic V, Johnson DW, Craig JC, Strippoli GF. HMG CoA reductase inhibitors (statins) for dialysis patients. Cochrane Database Syst Rev 2009 Jul 8;(3):CD004289 [Review content assessed as up-to-date: 29 February 2012].