Efficacy of statins on renal function in patients with chronic kidney disease: a systematic review and meta-analysis.

BACKGROUND

Studies have shown that the use of statins could significantly improve lipid profiles; however, it remains controversial whether the use of statins could improve renal function in patients with chronic kidney disease (CKD). Therefore, we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the effects of statins on renal function in patients with CKD.

METHODS

We systematically searched PubMed, EMBASE, and the Cochrane Library databases for eligible RCTs from inception to October 2020. Pooled effect estimates were assigned as weighted mean differences (WMDs) with 95% confidence intervals (CIs) using the random-effects model.

RESULTS

We selected 33 RCTs that recruited 37,391 patients with CKD patients. The summary results suggested that statin use significantly reduced urinary albumin (WMD: -2.04; 95%CI: -3.53 to -0.56;  = .007) and protein (WMD: -0.58; 95%CI: -0.95 to -0.21;  = .002) excretions and increased creatinine clearance (WMD: 0.86; 95%CI: 0.32-1.41;  = .002). However, there were no significant differences between statin and control groups in terms of changes in estimated glomerular filtration rate (WMD: 0.38; 95%CI: -0.04 to 0.79;  = .075), and serum creatinine levels (WMD: -0.07; 95%CI: -0.25, 0.12;  = .475).

CONCLUSIONS

We found that statin use in patients with CKD may slow CKD progression by lowering urinary albumin and protein excretions or increasing creatinine clearance. Further large-scale RCTs should be conducted to evaluate the long-term effects of statins on renal outcomes. CKD: chronic kidney disease; RCT: randomized controlled trials; WMD: weighted mean differences; CI: confidence intervals; ACEI: angiotensin-converting enzyme inhibitors; eGFR: estimated glomerular filtration rate.