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 language | English |
|---|---|
| Pages (from-to) | 2482-2489 |
| Number of pages | 8 |
| Journal | International Journal of Cardiology |
| Volume | 167 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2013 |
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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 journal › Article
}
TY - JOUR
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
Y1 - 2013
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.
KW - Atorvastatin
KW - Proteinuria
KW - Renal function
KW - Rosuvastatin
KW - Statins
UR - http://www.scopus.com/inward/record.url?scp=84883750690&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883750690&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2012.05.010
DO - 10.1016/j.ijcard.2012.05.010
M3 - Article
C2 - 22633671
AN - SCOPUS:84883750690
VL - 167
SP - 2482
EP - 2489
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 6
ER -