which statin can be use safely in kidney failure elderly?which is safer atorvastatin or rosuvastatin in elderly kidney failure? regards
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Thanks for your response,
Thanks for your question,
- Answered 6 Sep 2019 Conflict of interest declaration: None I couldn’t find anything definitive! A 2012 paper “Effects of rosuvastatin and atorvastatin on renal function: meta-analysis”  reported: “Both RSV and ATV improve GFR, and ATV seems to be more effective in reducing proteinuria. The validity and clinical significance require high-quality intensive studies with composite clinic endpoints of kidney and death” This was followed up by a similar review “Effects of atorvastatin and rosuvastatin on renal function: a meta-analysis”  the following year. This concluded: “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.” A study published this year in the Journal of the American Heart Association “Atorvastatin Has a Dose‐Dependent Beneficial Effect on Kidney Function and Associated Cardiovascular Outcomes: Post Hoc Analysis of 6 Double‐Blind Randomized Controlled Trials”  discusses rosuvastatin: “The PLANET studies showed a distinct effect of atorvastatin versus rosuvastatin treatment. Whereas atorvastatin 80 mg induced reduction of albuminuria and stabilization of eGFR, rosuvastatin led to higher albuminuria and decrement of eGFR.” I think the 2018 paper “Do Statins Induce or Protect from Acute Kidney Injury and Chronic Kidney Disease: An Update Review in 2018”  is worth a read, it discusses both drugs and has a section around the controversy of statins in CKD (it’s available as full-text via the reference section below). You didn’t specify diabetes but this has been studied in diabetics and I highlight a couple of important documents for interest [5, 6, 7] References 1) https://www.ncbi.nlm.nih.gov/pubmed/22382383 2) https://www.ncbi.nlm.nih.gov/pubmed/22633671 3) https://www.ahajournals.org/doi/full/10.1161/JAHA.118.010827 4) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5874483/ 5) http://www.diabetologists-abcd.org.uk/Position_Papers/ABCD_RA_Guidelines_Lipids_in_DN_&_or_DM_CKD_June_2015.pdf 6) https://www.ncbi.nlm.nih.gov/pubmed/28685516 7) https://www.sciencedirect.com/science/article/abs/pii/S2213858714702463