Moulin B, Caillard S
Service de Néphrologie, Hôpitaux Universitaires de Strasbourg, Hôpital Civil, BP 426, 67091 Strasbourg.
Ann Endocrinol (Paris). 2001 Feb;62(1 Pt 2):121-7.
Patients with chronic renal diseases (CRD) have a high prevalence of lipid abnormalities. Elevated levels of total and low density lipoprotein cholesterol are associated with cardiovascular diseases in patients with CRD. The 3-hydroxy-methylglutaryl co-enzyme A reductase inhibitors appear to be the most effective agents to lower LDL cholesterol in this category of patients and are generally safe if used with caution. They should be drugs of first choice in CRD but dosage reduction and close monitoring may be required to avoid side effects in case of renal failure or in combination with calcineurin inhibitors. Moreover recent studies suggest that in addition to lowering plasma LDL cholesterol, theses compounds may modify several factors implicated in the development of atherosclerosis and the progression of chronic renal failure. Such newly defined effects may contribute to extend the use of statins in the management of renal patients.
慢性肾脏病(CRD)患者脂质异常的患病率很高。总胆固醇和低密度脂蛋白胆固醇水平升高与CRD患者的心血管疾病相关。3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂似乎是降低此类患者低密度脂蛋白胆固醇最有效的药物,谨慎使用时一般是安全的。它们应该是CRD的首选药物,但在肾衰竭或与钙调神经磷酸酶抑制剂联合使用时,可能需要减少剂量并密切监测以避免副作用。此外,最近的研究表明,除了降低血浆低密度脂蛋白胆固醇外,这些化合物可能会改变与动脉粥样硬化发展和慢性肾衰竭进展相关的几个因素。这种新定义的作用可能有助于扩大他汀类药物在肾病患者管理中的应用。