Renal and Vascular Protective Effects of Ezetimibe in Chronic Kidney Disease

Tatsuyori Morita; Satoshi Morimoto; Chikara Nakano; Rika Kubo; Yoshiki Okuno; Maiko Seo; Kazunori Someya; Mitsutaka Nakahigashi; Hiroko Ueda; Nagaoki Toyoda; Makiko Kusabe; Fusakazu Jo; Nobuyuki Takahashi; Toshiji Iwasaka; Ichiro Shiojima

doi:10.2169/internalmedicine.53.0649

ORIGINAL ARTICLES

Renal and Vascular Protective Effects of Ezetimibe in Chronic Kidney Disease

Tatsuyori Morita, Satoshi Morimoto, Chikara Nakano, Rika Kubo, Yoshiki Okuno, Maiko Seo, Kazunori Someya, Mitsutaka Nakahigashi, Hiroko Ueda, Nagaoki Toyoda, Makiko Kusabe, Fusakazu Jo, Nobuyuki Takahashi, Toshiji Iwasaka, Ichiro Shiojima

Author information

Tatsuyori Morita
The Second Department of Internal Medicine, Kansai Medical University, Japan
Satoshi Morimoto
The Second Department of Internal Medicine, Kansai Medical University, Japan
Department of Medicine II, Endocrinology and Hypertension, Tokyo Women's Medical University, Japan
Chikara Nakano
The Second Department of Internal Medicine, Kansai Medical University, Japan
Rika Kubo
The Second Department of Internal Medicine, Kansai Medical University, Japan
Yoshiki Okuno
The Second Department of Internal Medicine, Kansai Medical University, Japan
Maiko Seo
The Second Department of Internal Medicine, Kansai Medical University, Japan
Kazunori Someya
The Second Department of Internal Medicine, Kansai Medical University, Japan
Mitsutaka Nakahigashi
The Second Department of Internal Medicine, Kansai Medical University, Japan
Hiroko Ueda
The Second Department of Internal Medicine, Kansai Medical University, Japan
Nagaoki Toyoda
The Second Department of Internal Medicine, Kansai Medical University, Japan
Makiko Kusabe
The Second Department of Internal Medicine, Kansai Medical University, Japan
Fusakazu Jo
The Second Department of Internal Medicine, Kansai Medical University, Japan
Nobuyuki Takahashi
The Second Department of Internal Medicine, Kansai Medical University, Japan
Toshiji Iwasaka
The Second Department of Internal Medicine, Kansai Medical University, Japan
Ichiro Shiojima
The Second Department of Internal Medicine, Kansai Medical University, Japan

Keywords: chronic kidney disease, cardiovascular disease, ezetimibe, brachial-ankle pulse wave velocity, intima-media thickness

JOURNAL OPEN ACCESS

2014 Volume 53 Issue 4 Pages 307-314

DOI https://doi.org/10.2169/internalmedicine.53.0649

J-STAGE : internalmedicine 54 13 pp.1683-1683

Details

Abstract

Objective Dyslipidemia is a risk factor for not only cardiovascular diseases (CVD), but also chronic kidney disease (CKD). Ezetimibe, a cholesterol absorption inhibitor, lowers cholesterol levels by inhibiting both extrinsic and intrinsic cholesterol absorption via the gastrointestinal duct. However, very few studies have examined its efficacy and safety for patients with dyslipidemia complicated with CKD.
Methods Thirty-seven dyslipidemic patients (low density lipoprotein cholesterol (LDL-C) levels ≥120 mg/dL) complicated with CKD were given ezetimibe (10 mg/day) for twenty-four weeks. The efficacy and safety of the therapy, including the anti-atherosclerotic and renal protective effects, were then examined.
Results Significant decreases were observed in the levels of LDL-C (158.9±26.9 mg/dL→123.0±31.8 mg/dL; p<0.0001), remnant-like lipoprotein cholesterol (9.3±5.3 mg/dL→7.3±3.8 mg/dL; p<0.05) and lipoprotein (a) (22.0±16.1 mg/dL→16.4±11.0 mg/dL; p<0.01). The estimated glomerular filtration rate did not change, but the urine protein to creatinine ratio decreased significantly (1,107.3±1,454.2 mg/gCre→732.1±1,237.8 mg/gCre; p<0.05). No changes were observed in the carotid intima media thickness, but the brachial-ankle pulse wave velocity decreased significantly (1,770.4±590.3 cm/sec→1,702.5±519.9 cm/sec; p<0.05). No adverse events were observed.
Conclusion Ezetimibe can be safely administered even to patients with CKD. The results of this study indicate that ezetimibe may provide some renal protection and suppress the complications of CVD in CKD patients.

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