Effects of atorvastatin on oxidative stress in chronic kidney disease

Aim: Statins have pleiotropic effects that include attenuation of oxidative stress that may be relevant for CKD patients. We investigated the effect of long term atorvastatin therapy on oxidative stress biomarkers in CKD patients.

Methods: This was a pre-specified secondary analysis of data from a randomized, double-blind, placebo-controlled trial (Lipid lowering and Onset of Renal Disease, LORD) in CKD patients. Participants received 10 mg/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.

Results: CKD 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) μmol/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) μmol/L, was due to a large decrease in the placebo group.

Conclusion: CKD patients had elevated oxidative stress that was not attenuated by atorvastatin 10mg/day for three-years.