$${{\rm{SD}}}_{change}=\sqrt{{{{\rm{SD}}}_{0}}^{2}+{{{\rm{SD}}}_{1}}^{2}-(2\ast Corr\ast {{\rm{SD}}}_{0}\ast {{\rm{SD}}}_{1})}$$$$Corr=\frac{{{{\rm{SD}}}_{0}}^{2}+{{{\rm{SD}}}_{1}}^{2}+{{{\rm{SD}}}_{change}}^{2}}{2\ast {{\rm{SD}}}_{0}\ast {{\rm{SD}}}_{1}}$$ For primary prevention of CVD, high-intensity statin treatment (atorvastatin 20 mg daily) should be offered to people: Aged 84 years and younger if their estimated 10-year risk of developing CVD using the QRISK assessment tool is 10% or more. With renal impairment — tetracyclines are excreted renally and may exacerbate renal failure. Effect of different types of statins on kidney function decline and proteinuria: a network meta-analysis All included publications were included in quantitative analyses, depending on the reported endpoint(s).Pairwise random effects meta-analysis of randomized controlled trials investigating the effect of statin therapy versus control on the rate of annual eGFR decline. doi: 10.1016/s0755-4982(06)74557-2. Clipboard, Search History, and several other advanced features are temporarily unavailable.

Since only a small number of RCTs with small sample sizes studied the effect of statins on proteinuria, we could not perform the aforementioned sensitivity analyses.In this network meta-analysis, we showed that there are no substantial differences in the efficacy of seven different statins and dosages, with or without ezetimibe, regarding slowing down eGFR decline or reducing proteinuria. 1,3 Given the risk of toxicity with high-dose statins, KDIGO recommends statin dosing based on regimens that have been studied and shown to be beneficial in randomized trials done specifically in patients with eGFR <60 mL/min/1.73 m 2. Elsevier Science As such, the Kidney Disease: Improving Global Outcomes guidelines recommend that GFR category G3 or G4 CKD patients not on dialysis should be treated with a statin without the need for routine follow-up to check lipid values, or to change medication dose regimens based … Negative values represent a reduction of proteinuria. Transitivity was judged clinically; consistency was judged formallyWe repeated the analyses excluding RCTs with a total sample size <100 patients or stratified by open-label (yes/no) or post-hoc (yes/no) status. 1 Because elderly patients tend to have poor renal function, it’s important to take CrCl into consideration when dosing medications that follow renal elimination. modifications induced by renal impairment. We only included RCTs because they are more likely to provide unbiased information. and JavaScript.Previous studies showed that statins reduce the progression of kidney function decline and proteinuria, but whether specific types of statins are more beneficial than others remains unclear. Nonetheless, we repeated the network meta-analysis for eGFR decline excluding RCTs with a sample size <100 (n = 16), excluding open-label RCTs (n = 17), or excluding post-hoc analyses (n = 20). You may also suffer liver damage, muscle damage, blood sugar spikes (which could increase your risk for type 2 diabetes), or digestive problems like diarrhea, gas, nausea, and constipation.If you have kidney failure and heart disease, it’s possible that the benefits of treatment with statin therapy will outweigh the risks. On the other hand, large-scale randomized clinical trials among CKD (4D) and renal transplant (ALERT) patients do not demonstrate that statins significantly decrease rates of cardiovascular disease. Effects are presented as weighted mean differences. Oral zinc is predicted to decrease the absorption of doxycycline. Egger, M., Davey Smith, G., Schneider, M. & Minder, C. Bias in meta-analysis detected by a simple, graphical test. You are using a browser version with limited support for CSS. All rights reserved. The SUCRA takes into account for every treatment the cumulative probabilities of all possible rankings.