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辛伐他汀对慢性肾脏病患者蛋白尿和肾功能的影响

The Effects of Simvastatin on Proteinuria and Renal Function in Patients with Chronic Kidney Disease.

作者信息

Satirapoj Bancha, Promrattanakun Anan, Supasyndh Ouppatham, Choovichian Panbuppa

机构信息

Division of Nephrology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok 10400, Thailand.

出版信息

Int J Nephrol. 2015;2015:485839. doi: 10.1155/2015/485839. Epub 2015 Oct 12.

Abstract

Current data suggests that statins might have beneficial effects on renal outcomes. Beneficial effects of statin treatment on renal progression in advanced chronic kidney disease (CKD) are obviously controversial. In a retrospective, controlled study, the authors have evaluated the effects of 53-week treatment with simvastatin, versus no treatment on proteinuria and renal function among 51 patients with CKD stages III-IV. By the end of the 53-week treatment, urine protein excretion decreased from 0.96 (IQR 0.54, 2.9) to 0.48 (IQR 0.18, 0.79) g/g creatinine (P < 0.001) in patients treated with simvastatin in addition to ACEI and ARBs, while no change was observed among the untreated patients. Moreover, a significantly greater decrease in urine protein excretion was observed in the simvastatin group as compared with the untreated group. The mean changes of serum creatinine and eGFR did not significantly differ in both groups. A significantly greater decrease in total cholesterol and LDL-cholesterol was found in the simvastatin group than in the untreated group. In summary, apart from lipid lowering among CKD patients, ingesting simvastatin was associated with a decrease in proteinuria. These statin effects may become important for supportive therapy in renal damage in the future.

摘要

目前的数据表明,他汀类药物可能对肾脏结局具有有益作用。他汀类药物治疗对晚期慢性肾脏病(CKD)肾脏进展的有益作用存在明显争议。在一项回顾性对照研究中,作者评估了51例III-IV期CKD患者接受辛伐他汀治疗53周与未治疗相比对蛋白尿和肾功能的影响。在53周治疗结束时,除接受ACEI和ARB治疗外还接受辛伐他汀治疗的患者,尿蛋白排泄量从0.96(四分位间距0.54,2.9)降至0.48(四分位间距0.18,0.79)g/g肌酐(P<0.001),而未治疗患者未观察到变化。此外,与未治疗组相比,辛伐他汀组尿蛋白排泄量的下降幅度明显更大。两组血清肌酐和估算肾小球滤过率(eGFR)的平均变化无显著差异。辛伐他汀组总胆固醇和低密度脂蛋白胆固醇的下降幅度明显大于未治疗组。总之,除了降低CKD患者的血脂外,服用辛伐他汀还与蛋白尿减少有关。这些他汀类药物的作用可能在未来对肾脏损伤的支持治疗中变得重要。

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Metabolic syndrome and its relation to chronic kidney disease in a Southeast Asian population.
Southeast Asian J Trop Med Public Health. 2011 Jan;42(1):176-83.
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Early recognition and prevention of chronic kidney disease.早期识别和预防慢性肾脏病。
Lancet. 2010 Apr 10;375(9722):1296-309. doi: 10.1016/S0140-6736(09)62004-3.

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