LONG-TERM EFFECT OF LOVASTATIN ON LIPOPROTEIN PROFILE IN PATIENTS WITH PRIMARY NEPHROTIC SYNDROME

Eight patients with biopsy-proven primary nephrotic syndrome were included in an open, prospective, two-year study of lovastatin. One patient was withdrawn after 6 months due to an asymptomatic rise in creatinine phosphokinase, which was rapidly reversed after interruption of lovastatin. In the remaining patients, treatment was well-tolerated and produced no side effects. After 2 years of treatment, these 7 patients had decreases in total cholesterol from 446+/-165 to 250+/-57 mg/dl (p <0.001), LDL cholesterol from 343+/-121 to 174+/-49 mg/dl (p <0.001), Apo B lipoprotein from 162+/-60 to 108+/-42 mg/dl (p <0.05), and triglycerides from 336+/-273 to 182+/-71 mg/dl (p <0.04). There was no change in HDL cholesterol. The LDL/HDL cholesterol and the total/HDL cholesterol ratios fell from 15.0+/-12.1 and 19.1+/-17.2 mg/dl before the study to 4.4+/-1.2 and 6.3+/-1.6 mg/dl, respectively, at 2 years. A decrease in proteinuria from 8.6+/-4.6 to 5.0+/-3.7 g/24 h (p <0.02) was noted in 4 patients on concomitant ACE inhibitor therapy. Renal function remained stable in all patients throughout the study, except for one whose moderate impairment progressed to end-stage renal failure requiring dialysis 3 months poststudy. We conclude that long-term lovastatin in patients with primary nephrotic syndrome is an effective and generally safe treatment for accompanying dyslipidemia.