Anti-Inflammatory Effects of 3-Hydroxy-3-Methylglutaryl Coenzyme a Reductase Inhibitors (Statins) in Peritoneal Dialysis Patients

Abstract

Objective

Elevated C-reactive protein (CRP) level is an independent predictor of all-cause and cardiovascular mortality in peritoneal dialysis (PD) patients. Statins have been demonstrated to have anti-inflammatory properties by virtue of their CRP lowering effects in hemodialysis patients. However, whether statins have an anti-inflammatory effect in PD patients is unknown.

Design

All prevalent PD patients at our center were reviewed. Eligible (257) patients were categorized into 2 groups: those on statin therapy (n = 137) and those not on statins (n = 120). Data were abstracted for hemoglobin, albumin, phosphates, cholesterol, CRP, Kt/V, and erythropoietin dose, along with relevant clinical data.

Results

The two groups had similar concentrations of hemoglobin, albumin, and phosphates. They were also matched for dialysis adequacy and duration of dialysis but the statin group patients were older (57 ± 13 vs 52 ± 17 years, p = 0.01). Serum cholesterol was lower in the statin group (4.74 ± 1.05 vs 5.02 ± 1.17 mmol/L, p < 0.05). Single-point (14 ± 13 vs 19 ± 18 mg/L, p < 0.02) and serially measured CRP (9 ± 7.4 vs 12 ± 10 mg/L, p < 0.02) levels were significantly lower in the statin group despite increased comorbidity (0.84 vs 0.54, p < 0.02) and greater incidence of diabetes mellitus (52% vs 25%, p < 0.01).

Conclusion

Statin therapy is associated with low single-point and serially measured CRP levels in PD patients, thereby suggesting that their anti-inflammatory properties persist in PD. These data have implications for considering statin therapy in PD patients as an anti-inflammatory agent in addition to a cholesterol lowering drug.