Department of Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran.
Department of Laboratory Sciences and Hematology, North Khorasan University of Medical Sciences, Bojnurd, Iran.
Curr Pharm Des. 2024;30(5):362-376. doi: 10.2174/0113816128285148240122112045.
Several studies have demonstrated the improvement in serum lipoproteins by statins in patients with Chronic Kidney Diseases (CKDs), including End-Stage Renal Disease (ESRD). However, the results of these studies are inconclusive.
We aimed to systematically investigate the effect of statins on lipid profiles of patients with CKD by performing a meta-analysis of Randomized Controlled Trials (RCTs).
Major electronic databases (Scopus, MEDLINE/PubMed, and ISI Web of Science) were searched from inception to August, 2023, to find randomized controlled trials (RCTs) evaluating the effect of different statins on serum lipoproteins in CKD patients. Weighted Mean Difference (WMD) with 95% Confidence Intervals (CI) was used to estimate the effect size. Trial Sequential Analysis (TSA) was performed to confirm the robustness of the evidence.
A total of 18 publications were identified. It was found that statins reduced serum levels of Low-Density Lipoprotein (LDL)-C (WMD = -27.81 mg/dl, 95% CI = -34.47 to -21.15, P < 0.001) and total cholesterol (WMD = -25.44 mg/dl, 95% CI = -34.71 to -16.18, P < 0.001) in patients with CKD compared to the control group. Nonetheless, the effect of statins on High-Density Lipoprotein (HDL)-C (WMD = 0.57 mg/dl, 95% CI = -0.71 to 1.85, P = 0.38) and Triglyceride (TG) (WMD = -9.08 mg/dl, 95% CI = -22.22 to 2.06, P = 0.11) was not statistically significant. The results of TSA confirmed the robustness of the evidence and were consistent with the pooled effect size. The findings of subgroup analysis and time response analysis were also significant.
It was found that statin therapy reduced the levels of LDL-C and total cholesterol in patients with CKD.
多项研究表明，他汀类药物可改善慢性肾脏病（CKD）患者的血清脂蛋白，包括终末期肾病（ESRD）患者。然而，这些研究的结果并不一致。
我们旨在通过对随机对照试验（RCT）进行荟萃分析，系统研究他汀类药物对 CKD 患者血脂谱的影响。
从创建到 2023 年 8 月，主要电子数据库（Scopus、MEDLINE/PubMed 和 ISI Web of Science）被搜索以寻找评估不同他汀类药物对 CKD 患者血清脂蛋白影响的随机对照试验（RCT）。使用加权均数差（WMD）和 95%置信区间（CI）来估计效应大小。进行试验序贯分析（TSA）以确认证据的稳健性。
共确定了 18 篇文献。结果表明，与对照组相比，他汀类药物可降低 CKD 患者的血清低密度脂蛋白（LDL）-C（WMD = -27.81 mg/dl，95%CI = -34.47 至 -21.15，P < 0.001）和总胆固醇（WMD = -25.44 mg/dl，95%CI = -34.71 至 -16.18，P < 0.001）水平。然而，他汀类药物对高密度脂蛋白（HDL）-C（WMD = 0.57 mg/dl，95%CI = -0.71 至 1.85，P = 0.38）和三酰甘油（TG）（WMD = -9.08 mg/dl，95%CI = -22.22 至 2.06，P = 0.11）的影响无统计学意义。TSA 的结果证实了证据的稳健性，并与汇总效应大小一致。亚组分析和时间反应分析的结果也有意义。
他汀类药物治疗可降低 CKD 患者的 LDL-C 和总胆固醇水平。
