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Pravastatin Therapy May Help Protect Kidney Function In Patients With Well-Controlled Hypertension
A DGReview of :"Effect of pravastatin on proteinuria in patients with well-controlled hypertension"
Hypertension
07/25/2002
By Andrew A. Skolnick
The addition of pravastatin to the treatment of well-controlled hypertension may reduce proteinuria and help protect patient kidney function.
Proteinuria is an important risk factor for cardiovascular and renal morbidity and mortality, say T.M. Lee and colleagues at the National Taiwan University Hospital, in Taipei, Taiwan, who conducted a clinical study of 63 proteinuric patients with well-controlled blood pressure.
The patients were randomized to receive either pravastatin or placebo, following a three-month placebo period. All patients had well-controlled blood pressure (less than 140/90 mmHg), relatively normal serum cholesterol (less than 240 mg/dl), and proteinuria (300 to 3000 mg/d).
Proteinuria in patients receiving pravastatin dropped 54 percent after six months, the researchers reported. Creatinine clearance was stable in both groups throughout the study. Despite unchanged plasma endothelin-1 levels, urinary excretion of the peptide decreased and was significantly correlated with improvement in urinary protein excretion in pravastatin-treated patients. The urinary excretion of retinol-binding protein decreased after pravastatin administration, probably reflecting an improvement in tubular function, the investigators said.
In contrast, urinary excretion of immunoglobulin G did not change significantly throughout the study in either group. Multivariate analysis showed that proteinuria was only significantly correlated with statin use. Linear regression analysis in the statin-treated group did not show any correlation between changes in lipid profiles and proteinuria regression.
"Thus, in addition to their primary function of antilipidemia, the addition of pravastatin to treatment for well-controlled hypertension may have an additive effect on reducing proteinuria independent of haemodynamics and lipid-lowering effects, possibly through inhibiting renal endothelin-1 synthesis and improving tubular function," the researchers concluded.
Hypertension 2002; 40: 67-73.
"Effect of pravastatin on proteinuria in patients with well-controlled hypertension"
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