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Pediatric Nephrology
Erschienen in: Pediatric Nephrology 3/2012

01.03.2012 | Educational Review

Dyslipidemia in children with CKD: should we treat with statins?

verfasst von: Kjell Tullus

Erschienen in: Pediatric Nephrology | Ausgabe 3/2012

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Abstract

Dyslipidemia has been shown to be a risk factor for increased cardiovascular morbidity and mortality in adult patients with chronic kidney disease (CKD) stages 2–4. In patients on dialysis, a paradoxical correlation has been found between low cholesterol values and increased mortality rates. No data exist in children. Treatment with statins has been convincingly shown to both reduce blood lipid levels and mortality rates from cardiovascular disease in adult patients in CKD stages 2–4. There is no strong literature support for treating patients on dialysis or after having had a transplant. Data on benefits of statin therapy do not exist in children with CKD. There are many differences between adult and paediatric kidney patients, and I caution on extrapolating the findings in adult patients to children. Studies are thus needed to evaluate the benefits and potential problems of statin treatment in children with CKD.
Literatur
1.
Foley RN, Parfrey PS, Sarnak MJ (1998) Clinical epidemiology of cardiovascular disease in chronic renal disease. Am J Kidney Dis 32:S112–S119PubMedCrossRef
2.
Covic A, Kanbay M, Voroneanu L, Turgut F, Serban DN, Serban IL, Goldsmith DJ (2010) Vascular calcification in chronic kidney disease. Clin Sci (Lond) 119:111–121CrossRef
3.
Querfeld U (2004) The clinical significance of vascular calcification in young patients with end-stage renal disease. Pediatr Nephrol 19:478–484PubMedCrossRef
4.
Muntner P, He J, Astor BC, Folsom AR, Coresh J (2005) Traditional and nontraditional risk factors predict coronary heart disease in chronic kidney disease: results from the atherosclerosis risk in communities study. J Am Soc Nephrol 16:529–538PubMedCrossRef
5.
Go AS, Chertow GM, Fan D, McCulloch CE, Hsu CY (2004) Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 351:1296–1305PubMedCrossRef
6.
Matsushita K, van der Velde M, Astor BC, Woodward M, Levey AS, de Jong PE, Coresh J, Gansevoort RT (2010) Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative meta-analysis. Lancet 375:2073–2081PubMedCrossRef
7.
Goodman WG, Goldin J, Kuizon BD, Yoon C, Gales B, Sider D, Wang Y, Chung J, Emerick A, Greaser L, Elashoff RM, Salusky IB (2000) Coronary-artery calcification in young adults with end-stage renal disease who are undergoing dialysis. N Engl J Med 342:1478–1483PubMedCrossRef
8.
Lilien MR, Groothoff JW (2009) Cardiovascular disease in children with CKD or ESRD. Nat Rev Nephrol 5:229–235PubMedCrossRef
9.
Groothoff JW, Lilien MR, van de Kar NC, Wolff ED, Davin JC (2005) Cardiovascular disease as a late complication of end-stage renal disease in children. Pediatr Nephrol 20:374–379PubMedCrossRef
10.
Hruska KA, Choi ET, Memon I, Davis TK, Mathew S (2010) Cardiovascular risk in chronic kidney disease (CKD): the CKD-mineral bone disorder (CKD-MBD). Pediatr Nephrol 25:769–778PubMedCrossRef
11.
Litwin M, Wuhl E, Jourdan C, Trelewicz J, Niemirska A, Fahr K, Jobs K, Grenda R, Wawer ZT, Rajszys P, Troger J, Mehls O, Schaefer F (2005) Altered morphologic properties of large arteries in children with chronic renal failure and after renal transplantation. J Am Soc Nephrol 16:1494–1500PubMedCrossRef
12.
Wilson AC, Mitsnefes MM (2009) Cardiovascular disease in CKD in children: update on risk factors, risk assessment, and management. Am J Kidney Dis 54:345–360PubMedCrossRef
13.
Kwan BC, Kronenberg F, Beddhu S, Cheung AK (2007) Lipoprotein metabolism and lipid management in chronic kidney disease. J Am Soc Nephrol 18:1246–1261PubMedCrossRef
14.
Iseki K, Yamazato M, Tozawa M, Takishita S (2002) Hypocholesterolemia is a significant predictor of death in a cohort of chronic hemodialysis patients. Kidney Int 61:1887–1893PubMedCrossRef
15.
Chmielewski M, Carrero JJ, Nordfors L, Lindholm B, Stenvinkel P (2008) Lipid disorders in chronic kidney disease: reverse epidemiology and therapeutic approach. J Nephrol 21:635–644PubMed
16.
Baigent C, Landray MJ, Wheeler DC (2007) Misleading associations between cholesterol and vascular outcomes in dialysis patients: the need for randomized trials. Semin Dial 20:498–503PubMedCrossRef
17.
Querfeld U (1993) Disturbances of lipid metabolism in children with chronic renal failure. Pediatr Nephrol 7:749–757PubMedCrossRef
18.
Saland JM, Pierce CB, Mitsnefes MM, Flynn JT, Goebel J, Kupferman JC, Warady BA, Furth SL (2010) Dyslipidemia in children with chronic kidney disease. Kidney Int 78:1154–1163PubMedCrossRef
19.
Silverstein DM, Palmer J, Polinsky MS, Braas C, Conley SB, Baluarte HJ (2000) Risk factors for hyperlipidemia in long-term pediatric renal transplant recipients. Pediatr Nephrol 14:105–110PubMedCrossRef
20.
Brugts JJ, Yetgin T, Hoeks SE, Gotto AM, Shepherd J, Westendorp RG, de Craen AJ, Knopp RH, Nakamura H, Ridker P, van Domburg R, Deckers JW (2009) The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials. BMJ 338:b2376PubMedCrossRef
21.
Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ (2009) Reduction in C-reactive protein and LDL cholesterol and cardiovascular event rates after initiation of rosuvastatin: a prospective study of the JUPITER trial. Lancet 373:1175–1182PubMedCrossRef
22.
de Jongh S, Ose L, Szamosi T, Gagne C, Lambert M, Scott R, Perron P, Dobbelaere D, Saborio M, Tuohy MB, Stepanavage M, Sapre A, Gumbiner B, Mercuri M, van Trotsenburg AS, Bakker HD, Kastelein JJ (2002) Efficacy and safety of statin therapy in children with familial hypercholesterolemia: a randomized, double-blind, placebo-controlled trial with simvastatin. Circulation 106:2231–2237PubMedCrossRef
23.
Wiegman A, Hutten BA, de Groot E, Rodenburg J, Bakker HD, Buller HR, Sijbrands EJ, Kastelein JJ (2004) Efficacy and safety of statin therapy in children with familial hypercholesterolemia: a randomized controlled trial. JAMA 292:331–337PubMedCrossRef
24.
Daniels SR, Greer FR (2008) Lipid screening and cardiovascular health in childhood. Pediatrics 122:198–208PubMedCrossRef
25.
de Ferranti S, Ludwig DS (2008) Storm over statins–the controversy surrounding pharmacologic treatment of children. N Engl J Med 359:1309–1312PubMedCrossRef
26.
Tonelli M, Moye L, Sacks FM, Kiberd B, Curhan G (2003) Pravastatin for secondary prevention of cardiovascular events in persons with mild chronic renal insufficiency. Ann Intern Med 138:98–104PubMed
27.
Tonelli M, Isles C, Curhan GC, Tonkin A, Pfeffer MA, Shepherd J, Sacks FM, Furberg C, Cobbe SM, Simes J, Craven T, West M (2004) Effect of pravastatin on cardiovascular events in people with chronic kidney disease. Circulation 110:1557–1563PubMedCrossRef
28.
Holdaas H, Wanner C, Abletshauser C, Gimpelewicz C, Isaacsohn J (2007) The effect of fluvastatin on cardiac outcomes in patients with moderate to severe renal insufficiency: a pooled analysis of double-blind, randomized trials. Int J Cardiol 117:64–74PubMedCrossRef
29.
Strippoli GF, Navaneethan SD, Johnson DW, Perkovic V, Pellegrini F, Nicolucci A, Craig JC (2008) Effects of statins in patients with chronic kidney disease: meta-analysis and meta-regression of randomised controlled trials. BMJ 336:645–651PubMedCrossRef
30.
Stegmayr BG, Brannstrom M, Bucht S, Crougneau V, Dimeny E, Ekspong A, Eriksson M, Granroth B, Grontoft KC, Hadimeri H, Holmberg B, Ingman B, Isaksson B, Johansson G, Lindberger K, Lundberg L, Mikaelsson L, Olausson E, Persson B, Stenlund H, Wikdahl AM (2005) Low-dose atorvastatin in severe chronic kidney disease patients: a randomized, controlled endpoint study. Scand J Urol Nephrol 39:489–497PubMedCrossRef
31.
Sharp Collaborative Group (2010) Study of Heart and Renal Protection (SHARP): randomized trial to assess the effects of lowering low-density lipoprotein cholesterol among 9,438 patients with chronic kidney disease. Am Heart J 160:785–794PubMedCrossRef
32.
Seliger SL, Weiss NS, Gillen DL, Kestenbaum B, Ball A, Sherrard DJ, Stehman-Breen CO (2002) HMG-CoA reductase inhibitors are associated with reduced mortality in ESRD patients. Kidney Int 61:297–304PubMedCrossRef
33.
Mason NA, Bailie GR, Satayathum S, Bragg-Gresham JL, Akiba T, Akizawa T, Combe C, Rayner HC, Saito A, Gillespie BW, Young EW (2005) HMG-coenzyme a reductase inhibitor use is associated with mortality reduction in hemodialysis patients. Am J Kidney Dis 45:119–126PubMedCrossRef
34.
Wanner C, Krane V, Marz W, Olschewski M, Mann JF, Ruf G, Ritz E (2005) Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med 353:238–248PubMedCrossRef
35.
Fellstrom BC, Jardine AG, Schmieder RE, Holdaas H, Bannister K, Beutler J, Chae DW, Chevaile A, Cobbe SM, Gronhagen-Riska C, De Lima JJ, Lins R, Mayer G, McMahon AW, Parving HH, Remuzzi G, Samuelsson O, Sonkodi S, Sci D, Suleymanlar G, Tsakiris D, Tesar V, Todorov V, Wiecek A, Wuthrich RP, Gottlow M, Johnsson E, Zannad F (2009) Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N Engl J Med 360:1395–1407PubMedCrossRef
36.
Holdaas H, Fellstrom B, Jardine AG, Holme I, Nyberg G, Fauchald P, Gronhagen-Riska C, Madsen S, Neumayer HH, Cole E, Maes B, Ambuhl P, Olsson AG, Hartmann A, Solbu DO, Pedersen TR (2003) Effect of fluvastatin on cardiac outcomes in renal transplant recipients: a multicentre, randomised, placebo-controlled trial. Lancet 361:2024–2031PubMedCrossRef
37.
Holdaas H, Fellstrom B, Jardine AG, Nyberg G, Gronhagen-Riska C, Madsen S, Neumayer HH, Cole E, Maes B, Ambuhl P, Logan JO, Staffler B, Gimpelewicz C (2005) Beneficial effect of early initiation of lipid-lowering therapy following renal transplantation. Nephrol Dial Transplant 20:974–980PubMedCrossRef
38.
Garcia-de-la-Puente S, Arredondo-Garcia JL, Gutierrez-Castrellon P, Bojorquez-Ochoa A, Maya ER, Perez-Martinez MP (2009) Efficacy of simvastatin in children with hyperlipidemia secondary to kidney disorders. Pediatr Nephrol 24:1205–1210PubMedCrossRef
39.
Butani L (2005) Prospective monitoring of lipid profiles in children receiving pravastatin preemptively after renal transplantation. Pediatr Transplant 9:746–753PubMedCrossRef
40.
Mahle WT, Vincent RN, Berg AM, Kanter KR (2005) Pravastatin therapy is associated with reduction in coronary allograft vasculopathy in pediatric heart transplantation. J Heart Lung Transplant 24:63–66PubMedCrossRef
41.
Avis HJ, Vissers MN, Stein EA, Wijburg FA, Trip MD, Kastelein JJ, Hutten BA (2007) A systematic review and meta-analysis of statin therapy in children with familial hypercholesterolemia. Arterioscler Thromb Vasc Biol 27:1803–1810PubMedCrossRef
42.
Sandhu S, Wiebe N, Fried LF, Tonelli M (2006) Statins for improving renal outcomes: a meta-analysis. J Am Soc Nephrol 17:2006–2016PubMedCrossRef
43.
Huskey J, Lindenfeld J, Cook T, Targher G, Kendrick J, Kjekshus J, Pedersen T, Chonchol M (2009) Effect of simvastatin on kidney function loss in patients with coronary heart disease: findings from the Scandinavian Simvastatin Survival Study (4 S). Atherosclerosis 205:202–206PubMedCrossRef
Metadaten
Titel
Dyslipidemia in children with CKD: should we treat with statins?
verfasst von
Kjell Tullus
Publikationsdatum
01.03.2012
Verlag
Springer-Verlag
Erschienen in
Pediatric Nephrology / Ausgabe 3/2012
Print ISSN: 0931-041X
Elektronische ISSN: 1432-198X
DOI
https://doi.org/10.1007/s00467-011-1872-3

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