Lower Cholesterol Has No Effect on Kidney Disease Progression
Cholesterol-lowering therapy is indicated in CKD patients to prevent CV risk.
Lowering low-density lipoprotein (LDL) cholesterol in patients with chronic kidney disease (CKD) does not significantly benefit renal progression, according to a study published online in the Journal of the American Society of Nephrology.
Richard Haynes, B.M., B.Ch., from the University of Oxford in the United Kingdom, and other SHARP (Study of Heart and Renal Protection) investigators randomly assigned 6,245 patients with CKD (not on dialysis) to simvastatin 20 mg plus ezetimibe 10 mg daily or matching placebo.
The researchers found that, over 4.8 years of follow-up, simvastatin plus ezetimibe resulted in an average LDL cholesterol difference of 0.96 mmol/L compared with placebo.
The incidence of end-stage renal disease (ESRD) was reduced nonsignificantly by 3 percent (33.9 percent of cases in the treatment arm versus 34.6 percent of cases with placebo; P = 0.41). Treatment had no significant effect on the pre-specified tertiary outcomes of ESRD or death (P = 0.34) or of ESRD or doubling of baseline creatinine (P = 0.09). No significant effect on the rate of change in estimated glomerular filtration rate was seen in exploratory analyses.
"Lowering LDL cholesterol by 1 mmol/L did not slow kidney disease progression within five years in a wide range of patients with CKD," the authors write.
The study was funded by Merck/Schering-Plough Pharmaceuticals.