The efficacy and safety of the 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors in chronic kidney disease, dialysis, and transplant patients

Ali Olyaei, Erin Greer, Rowena Delos Santos, Jose Rueda

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Coronary heart disease (CHD) is the leading cause of death in Western civilizations, in particular in chronic kidney disease (CKD) patients. Serum total cholesterol and LDL have been linked to the development of atherosclerosis and progression to CHD in the general population. However, the reductions of total and LDL cholesterol in the dialysis population have not demonstrated the ability to reduce the morbidity, mortality, and cost burden associated with CHD. The patients at greatest risk include those with pre-existing CHD, a CHD-risk equivalent, or multiple risk factors. However, data in the dialysis population are much less impressive, and the relationship between plasma cholesterol, cholesterol reduction, use of 3-hydroxy-3-methylglutaryl-CoA (HMG-CoA) reductase, and reduction in incidence of CHD or effect on progression of renal disease have not been proven. Adverse event information from published trials indicates that agents within this class share similar tolerability and adverse event profiles. Hepatic transaminase elevations may occur in 1 to 2% of patients and is dose related. Myalgia, myopathy, and rhabodmyolysis occur infrequently and are more common in kidney transplant patients and patients with CKD. This effect appears to be dose related and may be precipitated by administration with agents that inhibit cytochrome P-450 isoenzymes. Caution should be exercised when coadministering any statin with drugs that metabolize through cytochrome P-450 IIIA-4 in particular fibrates, cyclosporine, and azole antifungals. Elderly patients with CKD are at greater risk of adverse drug reactions, and therefore the lowest possible dose of statins should be used for the treatment of hyperlipidemia.

Original languageEnglish (US)
Pages (from-to)664-678
Number of pages15
JournalClinical Journal of the American Society of Nephrology
Volume6
Issue number3
DOIs
StatePublished - Mar 1 2011

Fingerprint

Hydroxymethylglutaryl CoA Reductases
Chronic Renal Insufficiency
Coronary Disease
Dialysis
Transplants
Safety
Hydroxymethylglutaryl-CoA Reductase Inhibitors
LDL Cholesterol
Cytochrome P-450 Enzyme System
Cholesterol
Population
Kidney
Fibric Acids
Civilization
Azoles
Aptitude
Myalgia
Muscular Diseases
Transaminases
Hyperlipidemias

ASJC Scopus subject areas

  • Nephrology
  • Transplantation
  • Epidemiology
  • Critical Care and Intensive Care Medicine

Cite this

The efficacy and safety of the 3-hydroxy-3-methylglutaryl-CoA reductase inhibitors in chronic kidney disease, dialysis, and transplant patients. / Olyaei, Ali; Greer, Erin; Delos Santos, Rowena; Rueda, Jose.

In: Clinical Journal of the American Society of Nephrology, Vol. 6, No. 3, 01.03.2011, p. 664-678.

Research output: Contribution to journalArticle

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