Goetz, Angela K. and Boger, Carsten A. and Hirschmann, C. and Schmitz, Gerd and Riegger, Guenter A. J. and Kraemer, Bernhard K. (2005) Effect of Hmg-CoA-reductase inhibitors on survival in type 2 diabetes patients with end stage diabetic nephropathy. EUROPEAN JOURNAL OF MEDICAL RESEARCH, 10 (4). pp. 155-160. ISSN 0949-2321,
Full text not available from this repository. (Request a copy)Abstract
Introduction: We studied the effect of HMG-CoA-reductase inhibitor (= CSE-I) treatment on mortality in a population of hemodialysis patients with diabetic nephropathy due to type 2 diabetes. Since the efficacy of CSE-I in dialysis patients is discussed controversially we tested the hypothesis that only patients with LDL-cholesterol > 100mg/dl benefit from CSE-I. Methods: We enrolled all 445 prevalent chronic hemodialysis patients with end-stage diabetic nephropathy from 30 centres in Southern Germany from August 1999 to January 2000 for prospective study until December 2003. Fasting lipid profiles prior to dialysis session and a complete clinical phenotype were determined at inclusion. We formed 2 patient groups (serum LDL > vs. <= 100 mg/dl). Only CSE-I were used as lipid lowering therapy in our cohort. 122 Patients were on CSE-I therapy during the study. All cause mortality (ACM) was the primary end point. Survival analysis was performed by Kaplan Meier and multivariare Cox regression analysis. Results: Multivariate regression analysis and Kaplan Meier survival analysis showed a decrease in risk for AGM for patients on CSE-I therapy, irrespective of lipid status (multi-variate hazard ratio HR) 0.58; p = 0.049; ACM 72.1% (no CSE-I) vs. 59.7% (+ CSE-I); mean survival 2.37 +/- 0.08 years (no CSE-I) vs. 2.77 +/- 0.12 years (+ CSE-I), p = 0.003). In patients with LDL > 100mg/dI, statin treatment was also associated with reduced ACM: 48.0% (+ CSE-I) vs. 70.1% (no CSE-I), (multivariate HR 0.28, CI 95% 0.11 - 0.75, p = 0.01), but not in patients with LDL <= S 100mg/dl (HR 0.84, CI 95% 0.41 - 1.72 p = 0.63). Conclusion: Our data indicates that hemodialysis patients with type 2 diabetic nephropathy may benefit from statin therapy irrespective of baseline LDL-cholesterol level. Patients with LDL > 100mg/dl benefit most when treated with CSE-I.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | CHRONIC-HEMODIALYSIS PATIENTS; DIALYSIS PATIENTS; CARDIOVASCULAR EVENTS; RENAL-FAILURE; INFLAMMATION; DISEASE; MALNUTRITION; LIPOPROTEIN; METABOLISM; MORTALITY; diabetic nephropathy; HMG-CoA-Reductase-Inhibitors; survival; dialysis; nephropharmacology |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 17 May 2021 04:59 |
| Last Modified: | 17 May 2021 05:00 |
| URI: | https://pred.uni-regensburg.de/id/eprint/36249 |
Actions (login required)
 |
View Item |
