Effects of Lowering LDL Cholesterol on Progression of Kidney Disease
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Effects of Lowering LDL Cholesterol on Progression of Kidney Disease. / Haynes, Richard; Lewis, David; Emberson, Jonathan; Reith, Christina; Agodoa, Lawrence; Cass, Alan; Craig, Jonathan C; de Zeeuw, Dick; Feldt-Rasmussen, Bo; Fellström, Bengt; Levin, Adeera; Wheeler, David C; Walker, Rob; Herrington, William G; Baigent, Colin; Landray, Martin J; SHARP Collaborative Group.
In: Journal of the American Society of Nephrology, Vol. 25, No. 8, 08.2014, p. 1825-1833.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Effects of Lowering LDL Cholesterol on Progression of Kidney Disease
AU - Haynes, Richard
AU - Lewis, David
AU - Emberson, Jonathan
AU - Reith, Christina
AU - Agodoa, Lawrence
AU - Cass, Alan
AU - Craig, Jonathan C
AU - de Zeeuw, Dick
AU - Feldt-Rasmussen, Bo
AU - Fellström, Bengt
AU - Levin, Adeera
AU - Wheeler, David C
AU - Walker, Rob
AU - Herrington, William G
AU - Baigent, Colin
AU - Landray, Martin J
AU - SHARP Collaborative Group
N1 - Copyright © 2014 by the American Society of Nephrology.
PY - 2014/8
Y1 - 2014/8
N2 - Lowering LDL cholesterol reduces the risk of developing atherosclerotic events in CKD, but the effects of such treatment on progression of kidney disease remain uncertain. Here, 6245 participants with CKD (not on dialysis) were randomly assigned to simvastatin (20 mg) plus ezetimibe (10 mg) daily or matching placebo. The main prespecified renal outcome was ESRD (defined as the initiation of maintenance dialysis or kidney transplantation). During 4.8 years of follow-up, allocation to simvastatin plus ezetimibe resulted in an average LDL cholesterol difference (SEM) of 0.96 (0.02) mmol/L compared with placebo. There was a nonsignificant 3% reduction in the incidence of ESRD (1057 [33.9%] cases with simvastatin plus ezetimibe versus 1084 [34.6%] cases with placebo; rate ratio, 0.97; 95% confidence interval [95% CI], 0.89 to 1.05; P=0.41). Similarly, allocation to simvastatin plus ezetimibe had no significant effect on the prespecified tertiary outcomes of ESRD or death (1477 [47.4%] events with treatment versus 1513 [48.3%] events with placebo; rate ratio, 0.97; 95% CI, 0.90 to 1.04; P=0.34) or ESRD or doubling of baseline creatinine (1189 [38.2%] events with treatment versus 1257 [40.2%] events with placebo; rate ratio, 0.93; 95% CI, 0.86 to 1.01; P=0.09). Exploratory analyses also showed no significant effect on the rate of change in eGFR. Lowering LDL cholesterol by 1 mmol/L did not slow kidney disease progression within 5 years in a wide range of patients with CKD.
AB - Lowering LDL cholesterol reduces the risk of developing atherosclerotic events in CKD, but the effects of such treatment on progression of kidney disease remain uncertain. Here, 6245 participants with CKD (not on dialysis) were randomly assigned to simvastatin (20 mg) plus ezetimibe (10 mg) daily or matching placebo. The main prespecified renal outcome was ESRD (defined as the initiation of maintenance dialysis or kidney transplantation). During 4.8 years of follow-up, allocation to simvastatin plus ezetimibe resulted in an average LDL cholesterol difference (SEM) of 0.96 (0.02) mmol/L compared with placebo. There was a nonsignificant 3% reduction in the incidence of ESRD (1057 [33.9%] cases with simvastatin plus ezetimibe versus 1084 [34.6%] cases with placebo; rate ratio, 0.97; 95% confidence interval [95% CI], 0.89 to 1.05; P=0.41). Similarly, allocation to simvastatin plus ezetimibe had no significant effect on the prespecified tertiary outcomes of ESRD or death (1477 [47.4%] events with treatment versus 1513 [48.3%] events with placebo; rate ratio, 0.97; 95% CI, 0.90 to 1.04; P=0.34) or ESRD or doubling of baseline creatinine (1189 [38.2%] events with treatment versus 1257 [40.2%] events with placebo; rate ratio, 0.93; 95% CI, 0.86 to 1.01; P=0.09). Exploratory analyses also showed no significant effect on the rate of change in eGFR. Lowering LDL cholesterol by 1 mmol/L did not slow kidney disease progression within 5 years in a wide range of patients with CKD.
KW - Aged
KW - Anticholesteremic Agents
KW - Azetidines
KW - Cholesterol, LDL
KW - Disease Progression
KW - Drug Therapy, Combination
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Incidence
KW - Kidney Failure, Chronic
KW - Kidney Transplantation
KW - Male
KW - Middle Aged
KW - Renal Dialysis
KW - Simvastatin
KW - Treatment Outcome
U2 - 10.1681/ASN.2013090965
DO - 10.1681/ASN.2013090965
M3 - Journal article
C2 - 24790178
VL - 25
SP - 1825
EP - 1833
JO - Journal of the American Society of Nephrology : JASN
JF - Journal of the American Society of Nephrology : JASN
SN - 1046-6673
IS - 8
ER -
ID: 138423658