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他汀类药物治疗糖尿病肾病患者:在肾功能受损患者他汀治疗的安全性和疗效之间取得平衡。

Statin therapy for patients with diabetic nephropathy: balance between safety and efficacy of statin treatment for patients with impaired kidney function.

机构信息

Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Pulau Pinang, Malaysia.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Nov;27(21):10595-10604. doi: 10.26355/eurrev_202311_34339.

Abstract

The International Diabetes Federation estimates that by 2035, there will be 592 million people with diabetes worldwide, substantially increasing from the 382 million patients with diabetes recorded in 2013. Diabetes-related nephropathy is a leading cause of end-stage renal disease. Recently, the therapeutic use of statins in patients with chronic kidney disease (CKD) was explored in a series of meta-analyses, which revealed their potential for decreasing mortality and cardiovascular complications in this population, although not in patients undergoing hemodialysis. The current study reviews the current state of knowledge on statin therapy regarding its safety and efficacy concerning renal outcomes in diabetic patients with CKD. The evidence shows that statins may offer a beneficial renoprotective effect in inhibiting the progression of renal function decline. This effect is time-dependent and particularly strong in patients with type 2 diabetes and nephropathy. In addition, whether certain statin types are more beneficial than others in slowing renal function loss and reducing proteinuria remains unclear. Prior research has not examined the impact of high-intensity statin therapy on CKD patient outcomes.

摘要

国际糖尿病联合会估计,到 2035 年,全球将有 5.92 亿人患有糖尿病,这一数字较 2013 年的 3.82 亿糖尿病患者大幅增加。糖尿病相关肾病是终末期肾病的主要原因。最近,在一系列荟萃分析中探讨了他汀类药物在慢性肾脏病(CKD)患者中的治疗用途,这些分析表明他汀类药物有可能降低该人群的死亡率和心血管并发症风险,尽管在接受血液透析的患者中没有发现这种效果。本研究回顾了他汀类药物治疗糖尿病合并 CKD 患者的安全性和疗效的现有知识状况。研究证据表明,他汀类药物可能通过抑制肾功能下降的进展来提供有益的肾脏保护作用。这种作用是时间依赖性的,在 2 型糖尿病和肾病患者中尤为明显。此外,某些他汀类药物是否比其他药物更能减缓肾功能丧失和减少蛋白尿,目前尚不清楚。之前的研究并未探讨高强度他汀类药物治疗对 CKD 患者结局的影响。

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