Nephrology and Internal Medicine Department, Faculty of Medicine, Alexandria University, Alkhartoom square, El azareeta, Alexandria, 21131, Egypt.
Int Urol Nephrol. 2022 Nov;54(11):2969-2976. doi: 10.1007/s11255-022-03231-3. Epub 2022 May 18.
Arterial stiffness is one of the vascular pathologies in hemodialysis (HD) patients with increased cardiovascular mortality and morbidity. Few approaches have been tested to reduce arterial stiffness in patients with chronic kidney disease (CKD). We aimed to assess effects of atorvastatin on arterial stiffness in hemodialysis patients.
This research is a double-blinded, placebo-controlled, randomized clinical trial which included 50 patients maintained on regular HD. Patients were allocated to receive 10 mg atorvastatin or placebo for 24 weeks. Aortic pulse wave velocity (PWV) as an index of large artery stiffness and augmentation index (AIx) as an index of wave reflections were assessed at baseline and after 6 months in both groups.
In atorvastatin group at study end, there was no significant difference from baseline findings in aortic PWV (7.86 ± 2.5 vs 7.88 ± 2.6 m/sec; p = 0.136), AIx (26.04 ± 8.5 vs 26.0 ± 8.6%; p = 0.714) and central pulse pressure (PP) (p = 1.0). On the other hand, in placebo group after 24 weeks, aortic PWV (7.80 ± 2.16 vs 7.63 ± 2.1 m/sec; p < 0.001), AIx (25.88 ± 9.4 vs 25.04 ± 9.4%; p < 0.001) increased significantly from baseline measurements but central pulse pressure (PP) (p = 0.870) did not. Also, the change (Δ) in aortic PWV and AIx was significantly higher than the change in the atorvastatin group with p value of < 0.001 and < 0.001, respectively.
Arterial stiffness parameters remained stable in atorvastatin group but increased significantly in placebo-treated patients suggesting a potential role for atorvastatin to delay arterial stiffness progression in HD patients. Larger randomized clinical trials are needed to confirm these findings.
ClinicalTrials.gov NCT04472637.
动脉僵硬度是血液透析（HD）患者血管病理学的一种表现，与心血管死亡率和发病率的增加有关。已经尝试了几种方法来降低慢性肾脏病（CKD）患者的动脉僵硬度。我们旨在评估阿托伐他汀对血液透析患者动脉僵硬度的影响。
本研究为双盲、安慰剂对照、随机临床试验，纳入 50 名维持常规 HD 的患者。患者被分配接受阿托伐他汀 10mg 或安慰剂治疗 24 周。在两组中，分别在基线和 6 个月时评估主动脉脉搏波速度（PWV）作为大动脉僵硬度的指标和增强指数（AIx）作为波反射的指标。
在阿托伐他汀组研究结束时，与基线相比，主动脉 PWV（7.86±2.5 与 7.88±2.6m/sec；p=0.136）、AIx（26.04±8.5 与 26.0±8.6%；p=0.714）和中心脉搏压（PP）（p=1.0）无显著差异。另一方面，在安慰剂组治疗 24 周后，主动脉 PWV（7.80±2.16 与 7.63±2.1m/sec；p<0.001）、AIx（25.88±9.4 与 25.04±9.4%；p<0.001）均显著高于基线测量值，但中心脉搏压（PP）（p=0.870）则不然。此外，主动脉 PWV 和 AIx 的变化（Δ）明显高于阿托伐他汀组，p 值分别为<0.001 和<0.001。
阿托伐他汀组动脉僵硬度参数保持稳定，但安慰剂治疗组显著增加，提示阿托伐他汀可能延缓 HD 患者动脉僵硬度的进展。需要更大规模的随机临床试验来证实这些发现。
ClinicalTrials.gov NCT04472637。
