Effects of atorvastatin and rosuvastatin on renal function: A meta-analysis

Gianluigi Savarese, Francesca Musella, Massimo Volpe, Francesco Paneni, Pasquale Perrone-Filardi

Research output: Contribution to journalArticle

Abstract

Background: Atorvastatin (A) and rosuvastatin (R) are highly effective and widely used statins. However, conflicting results have been reported regarding their renal effects. The aim of the present study was to compare the effects of A and R on glomerular filtration rate (GFR) and new onset proteinuria in patients at high cardiovascular risk. Methods: Randomized trials about A or R treatments reporting clinical end-points were included in the meta-analysis. Influence of both treatments on GFR and new onset proteinuria was assessed. Results: 23 trials enrolling 29,147 participants were included. A significant reduction in GFR was detected in placebo-treated compared to statin-treated patients (standard mean difference [SMD]: 0.056, 95% confidence interval [CI]:0.028 to 0.083, p <0.01). In particular, a significant reduction in GFR was detected in placebo as compared to either R-treated (SMD: 0.052, CI: 0.022 to 0.081, p = 0.001) or A-treated patients (SMD: 0.084, CI: 0.008 to 0.161, p = 0.031). No significant difference in GFR was detected in 5 head-to-head studies comparing A to R (SMD: 0.043, CI: - 0.041 to 0.126, p = 0.319). In 9 studies comparing A to R, R treatment significantly increased the risk of proteinuria when compared to A (odds ratio [OR]: 0.656, CI: 0.440 to 0.977, p = 0.038, heterogeneity p = 0.026), but this effect was no longer significant when studies using highest therapeutic doses of R (40 mg/daily) were excluded from analysis, abolishing significant heterogeneity (OR: 1.505, CI: 0.827 to 2.739, p = 0.181). Conclusions: A and R show similar reno-protective effects in patients at high cardiovascular risk, with comparable rates of new onset proteinuria when commonly used doses are considered.

Original languageEnglish
Pages (from-to)2482-2489
Number of pages8
JournalInternational Journal of Cardiology
Volume167
Issue number6
DOIs
Publication statusPublished - 2013

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Meta-Analysis
Glomerular Filtration Rate
Confidence Intervals
Kidney
Proteinuria
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Odds Ratio
Placebos
Therapeutics
Atorvastatin Calcium
Rosuvastatin Calcium

Keywords

  • Atorvastatin
  • Proteinuria
  • Renal function
  • Rosuvastatin
  • Statins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effects of atorvastatin and rosuvastatin on renal function : A meta-analysis. / Savarese, Gianluigi; Musella, Francesca; Volpe, Massimo; Paneni, Francesco; Perrone-Filardi, Pasquale.

In: International Journal of Cardiology, Vol. 167, No. 6, 2013, p. 2482-2489.

Research output: Contribution to journalArticle

Savarese, Gianluigi ; Musella, Francesca ; Volpe, Massimo ; Paneni, Francesco ; Perrone-Filardi, Pasquale. / Effects of atorvastatin and rosuvastatin on renal function : A meta-analysis. In: International Journal of Cardiology. 2013 ; Vol. 167, No. 6. pp. 2482-2489.
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abstract = "Background: Atorvastatin (A) and rosuvastatin (R) are highly effective and widely used statins. However, conflicting results have been reported regarding their renal effects. The aim of the present study was to compare the effects of A and R on glomerular filtration rate (GFR) and new onset proteinuria in patients at high cardiovascular risk. Methods: Randomized trials about A or R treatments reporting clinical end-points were included in the meta-analysis. Influence of both treatments on GFR and new onset proteinuria was assessed. Results: 23 trials enrolling 29,147 participants were included. A significant reduction in GFR was detected in placebo-treated compared to statin-treated patients (standard mean difference [SMD]: 0.056, 95{\%} confidence interval [CI]:0.028 to 0.083, p <0.01). In particular, a significant reduction in GFR was detected in placebo as compared to either R-treated (SMD: 0.052, CI: 0.022 to 0.081, p = 0.001) or A-treated patients (SMD: 0.084, CI: 0.008 to 0.161, p = 0.031). No significant difference in GFR was detected in 5 head-to-head studies comparing A to R (SMD: 0.043, CI: - 0.041 to 0.126, p = 0.319). In 9 studies comparing A to R, R treatment significantly increased the risk of proteinuria when compared to A (odds ratio [OR]: 0.656, CI: 0.440 to 0.977, p = 0.038, heterogeneity p = 0.026), but this effect was no longer significant when studies using highest therapeutic doses of R (40 mg/daily) were excluded from analysis, abolishing significant heterogeneity (OR: 1.505, CI: 0.827 to 2.739, p = 0.181). Conclusions: A and R show similar reno-protective effects in patients at high cardiovascular risk, with comparable rates of new onset proteinuria when commonly used doses are considered.",
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T1 - Effects of atorvastatin and rosuvastatin on renal function

T2 - A meta-analysis

AU - Savarese, Gianluigi

AU - Musella, Francesca

AU - Volpe, Massimo

AU - Paneni, Francesco

AU - Perrone-Filardi, Pasquale

PY - 2013

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N2 - Background: Atorvastatin (A) and rosuvastatin (R) are highly effective and widely used statins. However, conflicting results have been reported regarding their renal effects. The aim of the present study was to compare the effects of A and R on glomerular filtration rate (GFR) and new onset proteinuria in patients at high cardiovascular risk. Methods: Randomized trials about A or R treatments reporting clinical end-points were included in the meta-analysis. Influence of both treatments on GFR and new onset proteinuria was assessed. Results: 23 trials enrolling 29,147 participants were included. A significant reduction in GFR was detected in placebo-treated compared to statin-treated patients (standard mean difference [SMD]: 0.056, 95% confidence interval [CI]:0.028 to 0.083, p <0.01). In particular, a significant reduction in GFR was detected in placebo as compared to either R-treated (SMD: 0.052, CI: 0.022 to 0.081, p = 0.001) or A-treated patients (SMD: 0.084, CI: 0.008 to 0.161, p = 0.031). No significant difference in GFR was detected in 5 head-to-head studies comparing A to R (SMD: 0.043, CI: - 0.041 to 0.126, p = 0.319). In 9 studies comparing A to R, R treatment significantly increased the risk of proteinuria when compared to A (odds ratio [OR]: 0.656, CI: 0.440 to 0.977, p = 0.038, heterogeneity p = 0.026), but this effect was no longer significant when studies using highest therapeutic doses of R (40 mg/daily) were excluded from analysis, abolishing significant heterogeneity (OR: 1.505, CI: 0.827 to 2.739, p = 0.181). Conclusions: A and R show similar reno-protective effects in patients at high cardiovascular risk, with comparable rates of new onset proteinuria when commonly used doses are considered.

AB - Background: Atorvastatin (A) and rosuvastatin (R) are highly effective and widely used statins. However, conflicting results have been reported regarding their renal effects. The aim of the present study was to compare the effects of A and R on glomerular filtration rate (GFR) and new onset proteinuria in patients at high cardiovascular risk. Methods: Randomized trials about A or R treatments reporting clinical end-points were included in the meta-analysis. Influence of both treatments on GFR and new onset proteinuria was assessed. Results: 23 trials enrolling 29,147 participants were included. A significant reduction in GFR was detected in placebo-treated compared to statin-treated patients (standard mean difference [SMD]: 0.056, 95% confidence interval [CI]:0.028 to 0.083, p <0.01). In particular, a significant reduction in GFR was detected in placebo as compared to either R-treated (SMD: 0.052, CI: 0.022 to 0.081, p = 0.001) or A-treated patients (SMD: 0.084, CI: 0.008 to 0.161, p = 0.031). No significant difference in GFR was detected in 5 head-to-head studies comparing A to R (SMD: 0.043, CI: - 0.041 to 0.126, p = 0.319). In 9 studies comparing A to R, R treatment significantly increased the risk of proteinuria when compared to A (odds ratio [OR]: 0.656, CI: 0.440 to 0.977, p = 0.038, heterogeneity p = 0.026), but this effect was no longer significant when studies using highest therapeutic doses of R (40 mg/daily) were excluded from analysis, abolishing significant heterogeneity (OR: 1.505, CI: 0.827 to 2.739, p = 0.181). Conclusions: A and R show similar reno-protective effects in patients at high cardiovascular risk, with comparable rates of new onset proteinuria when commonly used doses are considered.

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