Acute versus Staged Introduction of Statins in Chronic Kidney Disease Patients.

Abstract

Background & Aim: Chronic kidney disease is any kidney structure or function abnormalities for 3 months or more. It is progression associated with poor health outcomes, increased cardiovascular (CV) complications, early death, and kidney failure. Statins are used to treat hypercholesteremia, so they are used as a principal therapy for the prevention of atherosclerosis & cardiovascular disease. We plan to determine the impact of acute versus gradual introduction of statin doses in CKD studied cases, to improve the tolerance of these studied cases, and gain protection of kidneys and cardiovascular system.

Methodology: This prospective study was conducted between March 2023 and October 2023 and one hundred and two patients were selected. Patients were categorized into two groups (51 in each): Group (A) on high-dose statins (80 mg) from the start, and Group (B) on low introduction of statins (5 mg) then the dose increased every 4 weeks. Follow-up was 6 months from the dose of the maximum tolerated statin. The up titration of statins was increasing the dose every 1 week by 10 mg. The group of high-intensity statins was 6 months from the start.
Results: Our analysis includes one hundred and two patients; they are 61 males (59.8%) and 41 females (40.2%) with a mean age of 58.25 ± 10.34. We found no difference among the 2groups regarding their comorbidities (hypertension, diabetes) (P-value =0.060, 0.550 respectively), and their levels of serum urea and creatinine (P-value =0.211, 0.058 respectively). We found a significant difference among the 2groups regarding liver follow-up profile (ALT, AST) (P-value = 0.007, 0.000 respectively) and creatine kinase follow-up (P-value = 0.002).
Conclusion: Gradual introduction of statin therapy has been better tolerated than immediate high-dose statin therapy in chronic kidney disease patients. These results support starting with low-dose statins & gradually increasing the dose to improve statin tolerance and protect liver and muscle function.