学術雑誌論文 Renoprotective effects of atorvastatin compared with pravastatin on progression of early diabetic nephropathy

Takazakura, Akiko  ,  Sakurai, Masaru  ,  Bando, Yukihiro  ,  Misu, Hirofumi  ,  Takeshita, Yumie  ,  Kita, Yuki  ,  Shimizu, Akiko  ,  Hayakawa, Tetsuo  ,  Kato, Ken-ichiro  ,  Kaneko, Shuichi  ,  Takamura, Toshinari

6 ( 3 )  , pp.346 - 353 , 2015-05-01 , Blackwell Publishing
ISSN:2040-1116
NII書誌ID(NCID):AA12488319
内容記述
Introduction: Several studies have shown that statins suppress the progression of diabetic nephropathy. However, few reports have directly compared the renoprotective effects between potent and conventional statins. Materials and Methods: Patients with diabetic nephropathy, selected as those with a serum creatinine level of 0.9-1.5 mg/dL and simultaneously having either microalbuminuria or positive proteinuria, were randomly assigned to one of three groups: a conventional diet therapy group, a group given 10 mg of pravastatin and a group given 10 mg of atorvastatin. Renal function was evaluated before and after a 12-month period of therapy. Results: The atorvastatin group had a significant decrease in low-density lipoprotein cholesterol at 3 months and thereafter compared with the other groups. The urinary albumin-to-creatinine ratio significantly decreased in the atorvastatin group; the degree of this decrease was significantly greater than that in the diet therapy group. The kidney function estimated with cystatin C (CysC) and the estimated glomerular filtration rate calculated from CysC were significantly preserved in the atorvastatin group compared with the pravastatin group. In a multivariate regression analysis, the use of atorvastatin was the only explanatory variable for the changes in CysC; this was independent of changes in low-density lipoprotein cholesterol. Conclusions: Atorvastatin is more effective than pravastatin for the prevention of increase in CysC, and this renoprotective effect was considered to a result of the pleiotropic effect of atorvastatin independent of its lipid-lowering effect. This study was registered with UMIN (no. UMIN 000001774). © 2014 The Authors.
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http://dspace.lib.kanazawa-u.ac.jp/dspace/bitstream/2297/45713/1/ME-PR-TAKAZAKURA-A-346.pdf

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