Effects of rosuvastatin and atorvastatin on renal function: meta-analysis.
Effects of rosuvastatin and atorvastatin on renal function: meta-analysis.
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DOI：
10.1253/circj.cj-11-1385
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发表时间：
2012-04
期刊：
影响因子：
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通讯作者：
Yongxia Wu;Yan Wang;Chuankai An;Zhe Dong;Hui Liu;Yun Zhang;Ming-Xiang Zhang;F. An
中科院分区：
文献类型：
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作者：
Yongxia Wu;Yan Wang;Chuankai An;Zhe Dong;Hui Liu;Yun Zhang;Ming-Xiang Zhang;F. An
背景：关于瑞舒伐他汀(RSV)和阿托伐他汀(ATV)对肾功能的影响，几项临床试验报道了不一致的结果。这项荟萃分析的目的是研究这两种他汀类药物对肾小球滤过率(GFR)和蛋白尿的影响，并确定哪一种更好。方法与结果检索PubMed、Central、Web of Knowledge和ClinicalTrials.gov网站，检索随机对照试验。符合条件的研究报告称，与对照组(安慰剂、不服用他汀类药物或常规护理)相比，RSV或ATV治疗期间出现肾小球滤过率和/或蛋白尿，或者RSV与ATV面对面比较。纳入透析参与者和青少年的试验被排除在外。使用I(2)统计量评估统计异质性，并使用随机效应模型合并结果。分别测量标准化均数差(SMD)和均数比(ROM值)来分析GFR和蛋白尿。确定了16项试验，总人数为24,278人。与对照组相比，RSV和ATV GFR的SMD变化分别为0.04(95%可信区间：0.01~0.07)和0.59(95%CI：0.12~1.06)。与对照组相比，RSV组蛋白尿的ROM值为0.59(95%CI：0.46~0.74)，头对头对照的ROM值为1.23(95%CI：1.05~1.43)。结论RSV和ATV均能改善肾小球滤过率，而ATV在减少蛋白尿方面似乎更有效。其有效性和临床意义需要对肾脏和死亡的复合临床终点进行高质量的深入研究。
BACKGROUND Several clinical trials have reported inconsistent findings for the effects of rosuvastatin (RSV) and atorvastatin (ATV) on renal function. The aim of this meta-analysis was to investigate the effects of these 2 statins on glomerular filtration rate (GFR) and proteinuria respectively, and determine which is better. METHODS AND RESULTS PubMed, CENTRAL, Web of Knowledge, and ClinicalTrials.gov website were searched for randomized controlled trials. Eligible studies reported GFR and/or proteinuria during treatment with RSV or ATV compared with control (placebo, no statins, or usual care), or RSV compared with ATV head to head. Trials that enrolled dialysis participants and teenagers were excluded. Statistical heterogeneity was assessed using the I(2) statistic, and pooled results using the random-effects model. The standardized mean differences (SMD) and ratio of means (ROM) were measured, respectively, to analyze GFR and proteinuria. Sixteen trials with a total number of 24,278 participants were identified. Compared with control, changes in the SMD of GFR were 0.04 (95% confidence interval [CI]: 0.01-0.07) and 0.59 (95%CI: 0.12-1.06) for RSV and ATV, respectively. The ROMs of proteinuria were 0.59 (95%CI: 0.46-0.74) for RSV vs. the control group, and 1.23 (95%CI: 1.05-1.43) in the head-to-head comparison. CONCLUSIONS Both RSV and ATV improve GFR, and ATV seems to be more effective in reducing proteinuria. The validity and clinical significance require high-quality intensive studies with composite clinic endpoints of kidney and death.