Effect of different types of statins drugs on kidney function decline and proteinuria

Contrast agents are widely used in diagnostic and therapeutic procedures today, and one of the most important complications of these agents is the development of contrast agent nephropathy. Renal failure that develops after the use of contrast media is associated with the need for hemodialysis, prolonged hospitalization, increased cost, increased mortality, and morbidity. Patients undergoing coronary angiography often have co-morbidities that predispose them to the development of contrast media nephropathy. Today, the effectiveness of statin therapy in cardiovascular primary and secondary prevention has been demonstrated. In addition to their lipid-lowering effects, there is evidence that statins, which have antioxidant, anti-inflammatory, and antithrombotic effects on vascular structure, have a role in the prevention of contrast media nephropathy in a few limited retrospective studies. This study aimed to determine whether adding HMG CoA-reductase inhibitor statins to immunosuppressive therapy in patients with primary glomerulonephritis provides an additional contribution to remission compared to those receiving only immunosuppressive therapy. For this purpose, a study was planned to evaluate the efficacy of statins on renal functions in the early period in patients scheduled for elective coronary angiography (CAG). A total of 180 patients who were planned to undergo elective coronary angiography at Baghdad Teaching Hospital were included in the study. The protocol of the study was approved by Baghdad University Clinical Research Ethics Committee. In order to evaluate the effectiveness of statin treatments, 180 patients were included in the study in 3 groups. The patients who were planned to undergo coronary angiography while using statin derivative drugs for at least 1 month, continued their statin treatment and were included in the study as the "chronic statin group" (80 patients). The patients whose coronary angiograms were planned electively, who did not use statins, and whose low-density lipoprotein (LDL) level was above 70 mg/dL were included in the control group (80 patients) and atorvastatin 40 mg/day (20 patients) groups, respectively. The patients in the atorvastatin group were started on atorvastatin 40 mg/day 3 days before the procedure. The average age of the participants was 59.8±9.7. Age, sex, body mass index, hypertension, diabetes, smoking, family history of coronary artery disease, left ventricular ejection fraction, presence of atrial fibrillation, history of cerebrovascular accident, anemia, and peripheral artery disease were all comparable between the three patient groups (p > 0.05). Statistically significant differences (p>0.05) in the presence of dyslipidemia, prior myocardial infarction, heart failure, coronary bypass surgery, and percutaneous coronary intervention were seen between the groups. Chronic statin users were more likely to have dyslipidemia, previous myocardial infarction, heart failure, percutaneous coronary intervention and CABG compared to those not taking statins (p<0.001, p=0.003, p=0.014, p=0.001, and p=0.027, respectively). In the atorvastatin group, the incidence of dyslipidemia was significantly higher than in the control group (p<0.001). The atorvastatin group and the control group showed no significant differences in any other clinical characteristics (p>0.05). Chronic statin users had a significantly greater incidence of dyslipidemia (p=0.001) and history of percutaneous coronary intervention (p=0.001) than atorvastatin users. Since only elective coronary angiography cases were included in the study, it can be said that the efficacy of statins in preserving renal functions is valid for this patient population.