Statins May Improve ESA Response in CKD Patients

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Using statins for more than 3 months was significantly associated with 85% lower odds of ESA hyporesponsiveness in CKD patients.
Using statins for more than 3 months was significantly associated with 85% lower odds of ESA hyporesponsiveness in CKD patients.

Statin therapy may curb hyporesponsiveness to erythropoiesis-stimulating agents (ESA) in predialysis patients with chronic kidney disease (CKD).

Of 232 Chinese patients with CKD initiating ESA therapy at Peking University People's Hospital, 77 (38.5%) had used statins for more than 3 months. After 6 months of ESA therapy, 6.5% of statin users and 17.1% of nonusers failed to achieve target hemoglobin levels at an ESA dose of 300 IU/kg/wk or more despite adequate iron therapy.

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Long-term statin use was significantly associated with 85% lower odds of ESA hyporesponsiveness, Zhun Sui, MD, and colleagues reported in Medicine. The team adjusted for demographics, baseline hemoglobin level, renal function, serum albumin, iron storage, lipid profile, and use of ACE inhibitors and angiotensin II receptor blockers.

Previous studies have found similar results in dialysis patients treated with statins and ESAs. Researchers posit that statins reduce chronic inflammation linked to ESA hyporesponsiveness. In the present study, investigators were unable to confirm an association possibly because they examined high sensitivity C-reactive protein rather than interleukin 6. They also could not usee the ESA-resistance index (ERI).

“It has been reported that poor ESA responders among patients with CKD are at a higher risk of cardiovascular events, death, and renal disease progression compared with patients that have a better response profile,” Dr Sui and colleagues concluded. “Therefore, the enhancement of ESA responsiveness among patients with CKD could potentially have important implications for clinical practice.”

Reference

Sui Z, Wang M, Zuo L. Statin therapy and erythropoiesis-stimulating agent hyporesponsiveness in patients with nondialysis chronic kidney disease: A retrospective study in Beijing, China. Med. DOI:10.1097/MD.0000000000013981

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