Evaluation of Pleiotropic Effects of Statins in Chronic Renal Failure Patients

OBJECTIVE: Atherosclerosis is seen more frequently in patients with chronic renal failure (CRF) due to the oxidative stress, chronic inflammation and endothelial dysfunction. Besides lowering total and low density lipoprotein (LDL) cholesterol levels, statins also lower the frequency of cardiovascular incidents in patients with chronic renal failure by their pleiotropic effects. We aimed to investigate whether atorvastatin had pleiotropic effects in dialysis patients.

MATERIAL and METHODS: 21 hyperlipidemic dialysis patients (12 on hemodialysis and 9 peritoneal dialysis) with LDL cholesterol levels over 130 mg/dl were included in this study. Atorvastatin was titrated and given to patients for 6 months. After LDL cholesterol level were reduced to under 100mg/day, we evaluated oxidized LDL, malondialdehyde (MDA), interleukin-6 (IL-6), high sensitive C reactive protein (hsCRP), fibrinogen, platelet count, sedimentation rate, nitric oxide (NO), Von Willebrand factor antigen (vWF ag), factor VIII (FVIII) and homocysteine.

RESULTS: Significant reductions were obtained in total cholesterol, LDL-cholesterol (p<0.001), triglyceride (p<0.05), oxidized LDL (p<0.001), sedimentation value (p<0.01) and platelet count (p<0.05) with atorvastatin treatment. No differences were seen in the other parameters.

CONCLUSION: Atorvastatin is associated with significant improvement of lipid profile and reduction of ox-LDL, platelet count, and sedimentation in dialysis patients.