“Lowering LDL cholesterol reduces the risk of developing atherosclerotic events in CKD, but the effects of such treatment on progression of kidney disease remain uncertain,” wrote researchers Richard Haynes, MB, BCh and colleagues in the Journal of the American Society of Nephrology.
After randomly assigning 6,245 patients with CKD (not on dialysis) to simvastatin 20 mg and ezetimbibe 10 mg daily, or a matching placebo, researchers found little reduction in end-stage renal disease in patients in the 4.8 years of follow-up.
Patients treated with simvastatin and exetimibe resulted in an average LDL cholesterol difference of 0.96 mmol/L compared to patients treated with the placebo.
Reduction of end-stage renal disease decreased 3% (33.9% in treated patients versus 34.6% in placebo patients, P=0.41), the researchers found.
Lowering LDL cholesterol had no significant effect on the pre-specified tertiary outcomes of ESRD or death (P=0.34) or of ESRD or doubling baseline creatinine (P=0.09).
There was also no significant effect on the rate of change in estimated glomerular filtration rate seen in exploratory analyses.
“Lowering LDL cholesterol by 1 mmol/L did not slow kidney disease progression within five years in a wide range of patients with CKD,” wrote the authors.