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DRUG INFORMATION ROUNDS

HMG-CoA Reductase Inhibitors for the Prevention of Nephropathy

Assistant Clinical Professor, Department of Clinical Pharmacy Practice, St. John's University College of Pharmacy and Allied Health Professions, Jamaica, NY; Clinical Coordinator, Internal Medicine, North Shore-Long Island Jewish Health System, New Hyde Park, NY

Kara K Pezzillo, PharmD

at time of writing, PharmD Student, St. John's University College of Pharmacy and Allied Health Professions; now, Pharmacist, ChemRx, Long Beach, NY

Reprints: Nicole M Maisch PharmD, Department of Clinical Pharmacy Practice, St. John's University College of Pharmacy and Allied Health Professions, St. Albert Hall, Rm. 114, 8000 Utopia Parkway, Jamaica, NY 11439-0001, fax 718/990-1986, maischn{at}stjohns.edu

OBJECTIVE: To evaluate the literature to determine whether hydroxymethylglutaryl coenzyme A reductase inhibitors are effective for the prevention of nephropathy.

DATA SOURCES: MEDLINE (1966–April 2003) and International Pharmaceutical Abstracts(1970–April 2003), as well as bibliographic searches, were conducted.

DATA SYNTHESIS: Although the statins are widely used for the prevention of coronary heart disease, non–lipid-lowering effects are also being investigated, namely their potential role in the prevention of nephropathy. Five trials of the statins used in this manner are reviewed, most of which included patients with dyslipidemias, making it difficult to determine whether the renoprotective effects were independent of the lipid-lowering effects.

CONCLUSIONS: Adequate evidence does not currently exist to support the widespread use of statins as alternatives to strategies known to prevent the progression of renal disease, but statins may be used to complement other therapies in patients with additional indications.

Key Words: hydroxymethylglutaryl coenzyme A reductase inhibitor, nephropathy, renal insufficiency, statins

Published Online, December 23, 2003. www.theannals.com, DOI 10.1345/aph.1D216

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