Statin Therapy and Lipid Indices in Chronic Kidney Disease: A Systematic Review and Meta-analysis of Randomized Control Trials


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Abstract

Background:Several studies have demonstrated the improvement in serum lipoproteins by statins in patients with Chronic Kidney Diseases (CKDs), including End-Stage Renal Disease (ESRD). However, the results of these studies are inconclusive.

Aims:We aimed to systematically investigate the effect of statins on lipid profiles of patients with CKD by performing a meta-analysis of Randomized Controlled Trials (RCTs).

Methods:Major electronic databases (Scopus, MEDLINE/PubMed, and ISI Web of Science) were searched from inception to August, 2023, to find randomized controlled trials (RCTs) evaluating the effect of different statins on serum lipoproteins in CKD patients. Weighted Mean Difference (WMD) with 95% Confidence Intervals (CI) was used to estimate the effect size. Trial Sequential Analysis (TSA) was performed to confirm the robustness of the evidence.

Results:A total of 18 publications were identified. It was found that statins reduced serum levels of Low-Density Lipoprotein (LDL)-C (WMD = -27.81 mg/dl, 95% CI = -34.47 to -21.15, p < 0.001) and total cholesterol (WMD = -25.44 mg/dl, 95% CI = -34.71 to -16.18, p < 0.001) in patients with CKD compared to the control group. Nonetheless, the effect of statins on High-Density Lipoprotein (HDL)-C (WMD = 0.57 mg/dl, 95% CI = -0.71 to 1.85, P = 0.38) and Triglyceride (TG) (WMD = -9.08 mg/dl, 95% CI = -22.22 to 2.06, P = 0.11) was not statistically significant. The results of TSA confirmed the robustness of the evidence and were consistent with the pooled effect size. The findings of subgroup analysis and time response analysis were also significant.

Conclusion:It was found that statin therapy reduced the levels of LDL-C and total cholesterol in patients with CKD.

About the authors

Jafar Karami

Department of Laboratory Sciences,, Khomein University of Medical Sciences

Email: info@benthamscience.net

Bahman Razi

Department of Laboratory Sciences and Hematology, North Khorasan University of Medical Sciences

Email: info@benthamscience.net

Danyal Imani

Department of Immunology, School of Public Health,, Tehran University of Medical Sciences

Author for correspondence.
Email: info@benthamscience.net

Saeed Aslani

Centre for Innate Immunity and Infectious Diseases,, Hudson Institute of Medical Research

Email: info@benthamscience.net

Mahdi Pakjoo

Department of Hematology, Faculty of Medicine,, Tarbiat Modares University

Email: info@benthamscience.net

Mahdieh Fasihi

Department of Immunology, School of Public Health,, Tehran University of Medical Sciences

Email: info@benthamscience.net

Keyhan Mohammadi

Department of Clinical Pharmacy, Faculty of Pharmacy,, Tehran University of Medical Sciences

Email: info@benthamscience.net

Amirhossein Sahebkar

Biotechnology Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences

Author for correspondence.
Email: info@benthamscience.net

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