Atorvastatin For Diabetic Nephropathy: Systemetic Review

Objective To assess the efficiency and safety of Atorvastatin for diabetic nephropathy.Methods To search MEDLINE,EMBASE,CENTRAL,CBM,CNKI,The search was concluded in December,2009.To evaluate the quality of randomized controlled trials assessing Atorvastatin for diabetic nephropathy.The data were calculated by the Cochrane Collaboration's software RevMan 5.0.Result Eight trials involving 631 participants with diabetic nephropathy were studied.There were 316 participants in Atorvastatin group and 315 participants in control group.(1)Meta-analysis indicated that for Atorvastatin was more effective than conventional therapy group in reducing UAER in 3rd stage DN [P<0.00001,SMD=1.69,95%CI(1.42,1.96)].The group of Atorvastatin combined ACEI/ARB treatment was more efffective than ACEI/ARB group in reducing UAER [P<0.00001,SMD=0.89,95%CI(0.58,1.20)].(2)The group of Atorvastatin combined ACEI/ARB treatment showed no statistic significant diffference in reducing SCR comparing to ACEI/ARB group in 3rd stage DN and 4th stage DN [P=0.13,SMD=0.58,95%CI(-0.17,1.33)],[P=0.79,SMD=-0.05,95%CI(-0.44,0.33)].(3)Atorvastatin can reduce blood LDL-C,TG,TC level [P<0.00001,SMD=0.89,95%CI(0.63,1.16)],[P=0.0003,SMD=1.03,95%CI(0.48,1.59)],[P<0.00001,SMD=1.75,95%CI(1.53,1.98)].Side effects were mentioned in six of eight studies.Three studies reported side effects as dizziness,nausea, disgorging,liver function damage,constipation,myosalgia,and these events were mostly mild.The other of three studies reported no side effect occurred.Conclusions Atorvastatin is effective in reducing blood LDL-C,TG,TC level.It may improve early DN renal function and reduce UAER,delay DN progressing.The risk is lower and side effect is mild.However the validity of this finding requires supports of more studies of larger size to evaluate the effect .