Abstract
Aims To compare the renal effects of low- vs. high-dose atorvastatin in patients with Type 2 diabetes mellitus and optimally managed early renal disease.Methods We compared the 2-year progression of nephropathy in a double-blind randomized controlled trial of atorvastatin 80 mg/day (n = 60) vs. 10 mg/day (n = 59) in patients with Type 2 diabetes with microalbuminuria or proteinuria [mean (sd): age 64 years (10 years); HbA1c 7.7% (1.3%), 61 mmol/mol (10 mmol/mol); blood pressure 131/73 mmHg; renin-angiotensin system blocker use > 80%; dual blockade > 67%] recruited from diabetes clinics in Greater Manchester.Results Over (mean) 2.1 years of follow-up, the Modification of Diet in Renal Disease estimated glomerular filtration rate declined by 3 ml min-1 1.73 m-2 in the combined group. The mean (95% CI) between-group difference during follow-up was not significant [2.2 ml min-1 1.73 m-2 (-1.1 to 5.4 ml min-1 1.73 m-2), P = 0.20] after adjusting for baseline differences in renal function; positive difference favours 80 mg dose. Similarly, there was no significant difference in creatinine clearance by Cockcroft and Gault [2.5 ml/min (-2.4 to 7.3 ml/min), P = 0.32]; serum creatinine/24-h urine collections [4.0 ml/min (-4.8 to 12.7 ml/min), P = 0.38]; cystatin C (P = 0.69); or 24-h urine protein or albumin excretion (P = 0.92; P = 0.93). We recorded no significant between-group differences in deaths or adverse events.Conclusions In patients with Type 2 diabetes with early renal disease, we found no statistical difference in renal function between those taking high- or low-dose atorvastatin over 2 years. We cannot exclude a beneficial effect of <1.6 ml min-1 1.73 m-2 year-1 on Modification of Diet in Renal Disease estimated glomerular filtration rate, or if blood pressure management or if renin-angiotensin system blocker use had not been optimized. © 2010 The Authors. Diabetic Medicine © 2010 Diabetes UK.
Original language | English |
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Pages (from-to) | 100-108 |
Number of pages | 8 |
Journal | Diabetic Medicine |
Volume | 28 |
Issue number | 1 |
DOIs | |
Publication status | Published - Jan 2011 |
Keywords
- 3-hydroxy-3-methyl-glutaryl-CoA reductase inhibitor
- Microalbuminuria
- Nephropathy
- Randomized control trial
- Type 2 diabetes