Do statins play a role in renoprotection?
Do statins play a role in renoprotection?
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他汀类药物在肾脏保护中发挥作用吗？
DOI：
10.1007/s10157-013-0928-z
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Mukoyama M
中科院分区：
文献类型：
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作者：
Kasahara M;Nakagawa T;Yokoi H;Kuwabara T;Yasuno S;Mori K;Mukoyama M
慢性肾脏病（CKD）不仅是一种以肾功能不全为特征的疾病，而且会加速心血管疾病的进展。近年来，慢性肾脏病的患病率与代谢综合征的患病率呈平行上升趋势，提示这两种疾病密切相关。代谢综合征通常以几种代谢和心血管特征为特征，包括肥胖、胰岛素抵抗和高血压，所有这些都已知会引起肾损害。因此，代谢综合征可能是肾脏疾病发展的关键因素。在与代谢综合征相关的几个因素中，脂质异常，特别是高水平的血清低密度脂蛋白，已成为肾损伤的原因。越来越多的证据表明，他汀类药物治疗高脂血症可以减缓肾脏疾病的进展，这表明脂质异常的治疗可能会阻止肾脏疾病的进展。换句话说，他汀类药物治疗除了对心血管系统的有益作用外，还可能具有肾脏保护作用。我们正在进行一项名为ASUCA的临床试验，研究他汀类药物是否可以减缓日本人群中CKD的进展。我们组织了多中心临床试验，以探讨阿托伐他汀对CKD和血脂异常患者估计肾小球滤过率的影响。在本文中，我们讨论了这一试验的概况和意义。
Chronic kidney disease (CKD) is not merely a disorder featuring renal dysfunction, but also accelerates the progression of cardiovascular disease. Recently, the prevalence of CKD has been increasing in parallel with that of metabolic syndrome, suggesting that these two disorders are closely related. Metabolic syndrome is generally characterized by several metabolic and cardiovascular features, including obesity, insulin resistance and hypertension, all of which are known to cause renal impairment. Hence, it is likely that metabolic syndrome could be a key factor in the development of renal disease. Among several factors associated with metabolic syndrome, lipid abnormality, in particular a high level of serum low-density lipoprotein, has been emerging as a cause of kidney injury. Accumulating evidence has demonstrated that statin therapy for treating hyperlipidemia could slow the progression of renal disease, indicating that a treatment for lipid abnormality might prevent the progression of renal disease. In other words, statin therapy might be renoprotective in addition to its beneficial effect on the cardiovascular system. We are carrying out a clinical trial, the ASUCA trial, in which we examine whether statins might slow the progression of CKD in the Japanese population. We organized the multi-center clinical trial to investigate the effect of atorvastatin on estimated glomerular filtration rate in patients with CKD and lipid abnormality. In this paper, we discuss the outline and significance of this trial.