Efficacy And Safety Evaluation Of Intensive Statin Therapy In Patients With Chronic Kidney Disease: A Meta-analysis

Background CKD is an independent risk factor for cardiovasculardisease, lipid-lowering therapy can improve the prognosis ofcardiovascular disease with CKD patients, but there remains controversialfor intensive statin therapy in CKD patients.Purpose By analyzing the current evidence in the literature toexplore the significance of rognostic for chronic kidney disease withintensive statin therapy.Methods Randomized controlled trials (RCTs) comparinghigh-intensity statin therapy with usual dose or placebo in patients withCKD were Searched in database "Pubmed","Cochrane Library","Ovidplatform" and "Web of science".data extraction and integration usingRevman5.1software. Results A total of4RCTs with9,274CKD patients were included inthe meta-analysis. There was no significant difference with the incidence ofall-cause mortality between the2arms (relative risk:0.84,95%confidenceinterval:0.68to1.04), nor of myocardial infarction (MI)(0.69,0.40to1.18), and heart failure (0.73,0.48to1.13). Subgroup analyses of patientswith cardiovascular disease (CVD) and CKD also showed thathigh-intensity statin therapy could only significantly reduce the incidenceof stroke (RR=0.69,95%CI0.55to0.85), but not all-cause mortality(RR=0.93,95%CI0.80to1.08), MI (RR=0.83,95%CI0.51to1.36), andheart failure (RR=0.73,95%CI0.48to1.13). Meanwhile, intensive statintherapy are more benefits in reducing LDL-C and improvement in eGFR.Conclusions The present meta-analysis suggests that high-intensitystatin therapy may reduce the risk of stroke in persons with CKD, but didnot decrease the incidence of all-cause mortality, nor of myocardialinfarction and heart failure, especially in patients with CKD and CVD. Theavailable evidence mainly comes from persons with moderate CKD.