Effects of lowering LDL cholesterol on progression of kidney disease.
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...
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Journal article |
| Language: | English |
| Published: |
2014
|
| _version_ | 1826289426409455616 |
|---|---|
| author | Haynes, R Lewis, D Emberson, J Reith, C Agodoa, L Cass, A Craig, J de Zeeuw, D Feldt-Rasmussen, B Fellström, B Levin, A Wheeler, D Walker, R Herrington, W Baigent, C Landray, M |
| author_facet | Haynes, R Lewis, D Emberson, J Reith, C Agodoa, L Cass, A Craig, J de Zeeuw, D Feldt-Rasmussen, B Fellström, B Levin, A Wheeler, D Walker, R Herrington, W Baigent, C Landray, M |
| author_sort | Haynes, R |
| collection | OXFORD |
| description | 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. |
| first_indexed | 2024-03-07T02:28:42Z |
| format | Journal article |
| id | oxford-uuid:a67d05e4-c632-48b1-955c-dfaab3c57a57 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T02:28:42Z |
| publishDate | 2014 |
| record_format | dspace |
| spelling | oxford-uuid:a67d05e4-c632-48b1-955c-dfaab3c57a572022-03-27T02:47:46ZEffects of lowering LDL cholesterol on progression of kidney disease.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:a67d05e4-c632-48b1-955c-dfaab3c57a57EnglishSymplectic Elements at Oxford2014Haynes, RLewis, DEmberson, JReith, CAgodoa, LCass, ACraig, Jde Zeeuw, DFeldt-Rasmussen, BFellström, BLevin, AWheeler, DWalker, RHerrington, WBaigent, CLandray, MLowering 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. |
| spellingShingle | Haynes, R Lewis, D Emberson, J Reith, C Agodoa, L Cass, A Craig, J de Zeeuw, D Feldt-Rasmussen, B Fellström, B Levin, A Wheeler, D Walker, R Herrington, W Baigent, C Landray, M Effects of lowering LDL cholesterol on progression of kidney disease. |
| title | Effects of lowering LDL cholesterol on progression of kidney disease. |
| title_full | Effects of lowering LDL cholesterol on progression of kidney disease. |
| title_fullStr | Effects of lowering LDL cholesterol on progression of kidney disease. |
| title_full_unstemmed | Effects of lowering LDL cholesterol on progression of kidney disease. |
| title_short | Effects of lowering LDL cholesterol on progression of kidney disease. |
| title_sort | effects of lowering ldl cholesterol on progression of kidney disease |
| work_keys_str_mv | AT haynesr effectsofloweringldlcholesterolonprogressionofkidneydisease AT lewisd effectsofloweringldlcholesterolonprogressionofkidneydisease AT embersonj effectsofloweringldlcholesterolonprogressionofkidneydisease AT reithc effectsofloweringldlcholesterolonprogressionofkidneydisease AT agodoal effectsofloweringldlcholesterolonprogressionofkidneydisease AT cassa effectsofloweringldlcholesterolonprogressionofkidneydisease AT craigj effectsofloweringldlcholesterolonprogressionofkidneydisease AT dezeeuwd effectsofloweringldlcholesterolonprogressionofkidneydisease AT feldtrasmussenb effectsofloweringldlcholesterolonprogressionofkidneydisease AT fellstromb effectsofloweringldlcholesterolonprogressionofkidneydisease AT levina effectsofloweringldlcholesterolonprogressionofkidneydisease AT wheelerd effectsofloweringldlcholesterolonprogressionofkidneydisease AT walkerr effectsofloweringldlcholesterolonprogressionofkidneydisease AT herringtonw effectsofloweringldlcholesterolonprogressionofkidneydisease AT baigentc effectsofloweringldlcholesterolonprogressionofkidneydisease AT landraym effectsofloweringldlcholesterolonprogressionofkidneydisease |