Chikatimalla Rahul, Trivedi Yash Vardhan, Ruhela Namita, Singh Shubhangi, Lal Amar, Pawa Akhil, Singh Baltej, Jain Rohit
Department of Medicine, Kamineni Institute of Medical Sciences, Narketpally, India.
Department of Medicine, Jawaharlal Nehru Medical College, Ajmer, India.
Postgrad Med. 2025 Sep 9:1-13. doi: 10.1080/00325481.2025.2548199.
Cardiovascular disease (CVD) and chronic kidney disease (CKD) are major global health concerns, with CKD significantly amplifying cardiovascular mortality. Statins, widely used to manage hyperlipidemia, are recognized for their lipid-lowering properties and additional benefits, including anti-inflammatory, antioxidant, and plaque-stabilizing effects. This review explores the multifaceted role of statins in cardiovascular and renal protection, particularly among CKD patients.
This narrative review synthesizes evidence from clinical studies assessing the cardiovascular and renal outcomes of statin use in patients with CKD. It examines the effects of statins across various clinical scenarios, demographics, and comorbidities, with a focus on their impact on cardiovascular events, renal function.
Statins significantly reduce all-cause mortality and major adverse cardiovascular events in patients with mild to moderate CKD, with evidence supporting their efficacy across diverse populations. Trials such as JUPITER and the Heart Protection Study highlight their cardiovascular benefits and potential to stabilize kidney function. In surgical settings, statins show promise in mitigating acute kidney injury through inflammatory pathway modulation. However, their impact on renal outcomes, such as proteinuria, albuminuria, and glomerular filtration rate, is inconsistent. High-dose statins, especially in advanced CKD, may carry risks including hematuria or rhabdomyolysis, particularly with improper dosing or drug interactions. Safety depends on statin type, dose, and renal function. Additionally, statins reduce the risk of contrast-induced nephropathy and slow CKD progression in select populations, though variability in study designs limits generalizability.
Statins provide substantial cardiovascular benefits for CKD patients, but their renal effects remain uncertain. Future research should aim to optimize treatment strategies, including personalized regimens, to balance cardiovascular protection and renal safety effectively.
心血管疾病（CVD）和慢性肾脏病（CKD）是全球主要的健康问题，CKD会显著增加心血管疾病死亡率。他汀类药物广泛用于治疗高脂血症，以其降脂特性及抗炎、抗氧化和稳定斑块等额外益处而闻名。本综述探讨他汀类药物在心血管和肾脏保护方面的多方面作用，特别是在CKD患者中。
本叙述性综述综合了评估CKD患者使用他汀类药物的心血管和肾脏结局的临床研究证据。它考察了他汀类药物在各种临床场景、人口统计学和合并症中的作用，重点关注其对心血管事件、肾功能的影响。
他汀类药物可显著降低轻度至中度CKD患者的全因死亡率和主要不良心血管事件，有证据支持其在不同人群中的疗效。如JUPITER试验和心脏保护研究等试验突出了它们的心血管益处以及稳定肾功能的潜力。在手术环境中，他汀类药物通过调节炎症途径在减轻急性肾损伤方面显示出前景。然而，它们对蛋白尿、白蛋白尿和肾小球滤过率等肾脏结局的影响并不一致。高剂量他汀类药物，尤其是在晚期CKD患者中，可能存在包括血尿或横纹肌溶解等风险，特别是在给药不当或存在药物相互作用的情况下。安全性取决于他汀类药物的类型、剂量和肾功能。此外，他汀类药物可降低特定人群中造影剂诱导的肾病风险并减缓CKD进展，不过研究设计的差异限制了其普遍性。
他汀类药物为CKD患者提供了显著的心血管益处，但其对肾脏的影响仍不确定。未来的研究应旨在优化治疗策略，包括个性化方案，以有效平衡心血管保护和肾脏安全性。
