Evaluation of Effect of Statins on Erythropoietin Resistance in Patients of Chronic Kidney Disease on Maintenance Haemodialysis.

METHODS

Thirty adult patients of end stage renal disease with erythropoietin hyporesponsiveness undergoing maintenance hemodialysis were included in the study. Patients were divided randomly into two groups of 15 patients each. Group A were given atorvastatin in a dose of 20 mg once daily for a period of 4 months along with erythropoietin 6000 IU S/C and IV iron 100mg twice weekly after each hemodialysis. Group B was given erythropoietin 6000 IU S/C and IV iron 100 mg twice weekly after each hemodialysis without addition of atorvastatin for 4 months. Hematological, renal parameters, inflammatory parameters such as erythrocyte sedimentation rate, highly sensitive C reactive protein, serum ferritin and erythropoietin resistance index were done at baseline and then two monthly intervals for 4 months.

RESULTS

At the end of study, in group A hemoglobin and haematocrit significantly increased (p <0.001 for both) while HsCRP, ESR and erythropoietin resistance index decreased significantly (p=0.001, 0.001 and <0.001 respectively). In group B, the increase in hemoglobin and haematocrit were not statistically significant (p >0.05) similarly fall in HsCRP and ERI were also not significant statistically (p >0.05). The mean rise in hemoglobin between subsequent months was higher in group A as compared to group B which was statically significant.

CONCLUSION

Statin can be used as an adjuvant to erythropoietin in management of anemia in patients of chronic kidney disease, who show hyporesponsiveness to increased doses of erythropoietin, by its anti-inflammatory properties.