Alotaibi Abdulmalik S, Albekery Mohamed A, Alanazi Ahmed A, Alhomoud Ibrahim S, Alamer Khalid A, Shawaqfeh Mohammad, Alshammari Reem H, Alhejaili Fayez, Al Sahlawi Muthana, Aldossary Ibrahim, Aljuayl Hajar Adel, Alkathiri Mohammad, Alharbi Shmeylan, Albekairy Abdulkareem, Alkatheri Abdulmalik
Pharmaceutical Practices Department, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia.
Department of Pharmacy Practice, College of Clinical Pharmacy, King Faisal University, Al-Ahsa 31982, Saudi Arabia.
Pharmaceuticals (Basel). 2025 Jun 18;18(6):911. doi: 10.3390/ph18060911.
Lipid metabolism disturbances are common in end-stage renal disease (ESRD) patients on hemodialysis (HD), leading to dyslipidemia, which is characterized by abnormal plasma lipids and lipoproteins. Although large randomized controlled trials have generally not demonstrated a survival benefit associated with statin therapy among patients receiving hemodialysis, limited observational studies have reported potential associations with improved clinical outcomes in this population. : This retrospective cohort study investigated the clinical and safety outcomes of statin use in ESRD patients on HD with documented dyslipidemia over a two-year period from 1 January 2018 to 30 December 2019. The primary endpoints evaluated the clinical outcomes of statins by assessing changes in specific lipid parameters, including low-density lipoprotein cholesterol (LDL-C), triglycerides (TG), total cholesterol (TC), and high-density lipoprotein cholesterol (HDL-C). The secondary endpoints assessed safety by monitoring liver enzymes and creatine kinase (CK) levels. : Among 179 participants, diabetes mellitus was present in 134 patients (74.9%), while 168 patients (93.9%) had hypertension. Cardiovascular events occurred in 95 patients (53.1%). Statin therapy was administered to 146 patients (82.0%), with atorvastatin being the most frequently prescribed statin (69.3%). Modest reductions in LDL-C levels were observed in the rosuvastatin and atorvastatin groups, whereas slight increases were noted in the simvastatin and non-statin groups. None of these within-group changes were statistically significant. In the atorvastatin group, LDL-C decreased slightly from 2.058 to 2.003 mmol/L. The rosuvastatin group experienced a more pronounced LDL-C reduction from 2.607 to 2.113 mmol/L. Conversely, the simvastatin group showed an LDL-C increase from 1.550 to 1.901 mmol/L. Among the non-statin group, LDL-C increased from 2.678 to 2.820 mmol/L. Liver enzyme and CK levels fluctuated slightly but remained within normal ranges. : This study evaluated statin therapy in hemodialysis patients with dyslipidemia. Although modest reductions in LDL-C levels were observed in the atorvastatin and rosuvastatin groups, statin therapy did not reduce the incidence of atherosclerotic events in hemodialysis patients with dyslipidemia. Additionally, statin use was not associated with any clinically or statistically significant effects.
脂质代谢紊乱在接受血液透析（HD）的终末期肾病（ESRD）患者中很常见，会导致血脂异常，其特征是血浆脂质和脂蛋白异常。尽管大型随机对照试验一般未证明他汀类药物治疗对接受血液透析的患者有生存益处，但有限的观察性研究报告了该人群中他汀类药物与改善临床结局之间的潜在关联。本回顾性队列研究调查了2018年1月1日至2019年12月31日期间有血脂异常记录的HD-ESRD患者使用他汀类药物的临床和安全性结局。主要终点通过评估特定脂质参数的变化来评估他汀类药物的临床结局，这些参数包括低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）、总胆固醇（TC）和高密度脂蛋白胆固醇（HDL-C）。次要终点通过监测肝酶和肌酸激酶（CK）水平来评估安全性。在179名参与者中，134名患者（74.9%）患有糖尿病，而168名患者（93.9%）患有高血压。95名患者（53.1%）发生了心血管事件。146名患者（82.0%）接受了他汀类药物治疗，其中阿托伐他汀是最常用的他汀类药物（69.3%）。瑞舒伐他汀和阿托伐他汀组的LDL-C水平有适度降低，而辛伐他汀组和非他汀组则有轻微升高。这些组内变化均无统计学意义。在阿托伐他汀组中，LDL-C从2.058 mmol/L略有下降至2.003 mmol/L。瑞舒伐他汀组的LDL-C下降更为明显，从2.607 mmol/L降至2.113 mmol/L。相反，辛伐他汀组的LDL-C从1.550 mmol/L升至1.901 mmol/L。在非他汀组中，LDL-C从2.678 mmol/L升至2.820 mmol/L。肝酶和CK水平略有波动，但仍在正常范围内。本研究评估了血脂异常的血液透析患者使用他汀类药物的情况。尽管阿托伐他汀组和瑞舒伐他汀组的LDL-C水平有适度降低，但他汀类药物治疗并未降低血脂异常的血液透析患者动脉粥样硬化事件的发生率。此外，使用他汀类药物未产生任何临床或统计学上的显著影响。
