Effects of atorvastatin on oxidative stress in chronic kidney disease

AimStatins have pleiotropic effects that include attenuation of oxidative stress that may be relevant for chronic kidney disease (CKD) patients. We investigated the effect of long-term atorvastatin therapy on oxidative stress biomarkers in CKD patients. MethodsThis was a pre-specified secondary analysis of data from a randomized, double-blind, placebo-controlled trial (LORD) in CKD patients. Participants received 10mg/day atorvastatin (n=47) or placebo (n=39) for 3 years. Plasma measures (total F2-isoprostanes, malondialdehyde. protein carbonyls, uric acid, glutathione peroxidase (GPx) activity and total antioxidant capacity (TAC)) were performed at baseline and at 3 years. Age and sex matched participants (n=34) with normal kidney function were controls. ResultsCKD patients had significantly (P<0.05) increased F2-isoprostanes and uric acid and decreased GPx activity compared with controls. When comparing the treatment (atorvastatin (A) vs placebo (P)) change from baseline to 3 years, there were no significant differences (P>0.05) in the group difference of the change values: (mean (95% CI), F2-isoprostanes=5.3 (-29.2 to 39.8) pg/mL, protein carbonyls=0.03 (-0.13 to 0.19) nmol/mg, GPx activity=-0.10 (-4.73 to 4.52) (U/L), uric acid=8.8 (-33.9 to 51.6) mol/L or TAC=-0.03 (-0.10 to 0.04) mmol/L. A significant difference (P=0.04) in the change in malondialdehyde between groups, 1.52(0.09 to 2.96) mol/L, was due to a large decrease in the placebo group. ConclusionCKD patients had elevated oxidative stress that was not attenuated by atorvastatin 10mg/day for 3 years. Summary at a Glance These authors report a post hoc analysis of a randomized controlled trial of the effect of atorvastatin 10mg daily versus placebo on oxidative stress in patients with chronic kidney disease. They demonstrated that therapy with atorvastatin did not reduce markers of oxidative stress over a 3 year period.