Document Detail


Why do we need a statin trial in hemodialysis patients?
MedLine Citation:
PMID:  12694345     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The risk of cardiovascular complications is markedly increased in patients on dialysis treatment. This includes cardiac disease, stroke, and peripheral vascular disease. The mortality in dialysis patients is markedly higher compared to a nonuremic population. There are several cardiovascular (CV) risk factors that are unique to this population, one of which is dyslipidemia. Uremic patients do not usually develop hypercholesterolemia, but rather are characterized by high levels of very low density lipoprotein (VLDL) triglycerides, low high density lipoprotein (HDL) cholesterol, and elevated levels of modified low density lipoprotein (LDL) particles, which are particularly harmful to the vascular wall. HMG-CoA reductase inhibitors (statins) have been proven to be very efficient in reducing CV events in a nonrenal population. There are several landmark trials that have demonstrated that statins reduce the mortality in cardiovascular disease (CVD) in populations with normal, or close to normal, renal function. There are some observational registry data indicating that this may also be true in hemodialysis (HD) patients, but no prospective controlled trial has been performed to date. METHODS: We present the rationale for, and a brief outline of, a randomized placebo-controlled trial using a novel drug, rosuvastatin, in HD patients, to target cardiovascular events (the AURORA study). This study will include close to 3000 male and female HD patients, aged 50-80 years. The study is event driven and it has been estimated that it will run for a follow-up time close to four years. CONCLUSION: There is a sound rationale for making a randomized placebo-controlled statin trial in HD patients, with the objective to demonstrate an effect on CV mortality and morbidity.
Authors:
Bengt C Fellström; Hallvard Holdaas; Alan G Jardine
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Kidney international. Supplement     Volume:  -     ISSN:  0098-6577     ISO Abbreviation:  Kidney Int. Suppl.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-04-15     Completed Date:  2003-07-16     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7508622     Medline TA:  Kidney Int Suppl     Country:  United States    
Other Details:
Languages:  eng     Pagination:  S204-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, Western Infirmary, Glasgow, United Kingdom. Bengt.Fellstrom@medsci.uu.se
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MeSH Terms
Descriptor/Qualifier:
Antilipemic Agents / therapeutic use*
Fluorobenzenes / therapeutic use*
Humans
Hyperlipidemias / drug therapy*,  epidemiology
Kidney Failure, Chronic / epidemiology,  therapy*
Pyrimidines*
Randomized Controlled Trials as Topic / methods
Renal Dialysis*
Risk Factors
Sulfonamides*
Uremia / epidemiology,  therapy
Chemical
Reg. No./Substance:
0/Antilipemic Agents; 0/Fluorobenzenes; 0/Pyrimidines; 0/Sulfonamides; 287714-41-4/rosuvastatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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