Cholesterol-Lowering Treatment in Chronic Kidney Disease : Multistage Pairwise and Network Meta-Analyses
Herrera Gómez, Francisco (Hospital Virgen de la Concha (Zamora))
Chimeno, M. Montserrat (Hospital Virgen de la Concha (Zamora))
Martín García, Débora (Hospital Clínico Universitario de Valladolid)
Lizaraso Soto, Frank (Instituto de Investigación de la Facultad de Medicina Humana. Universidad de San Martín de Porres)
Maurtua Briseño Meiggs, Álvaro (Woodland Medical Practice - NHS)
Grande Villoria, Jesús (Hospital Virgen de la Concha (Zamora))
Bustamante-Munguira, Juan (Hospital Clínico Universitario de Valladolid)
Alamartine, Eric (Nephrology. Dialysis and Transplantation. Centre Hospitalier Universitaire de Saint-Etienne)
Vilardell, Miquel 1946- (Universitat Autònoma de Barcelona. Departament de Medicina)
Ochoa Sangrador, Carlos (Hospital Virgen de la Concha (Zamora))
Álvarez, F. Javier (Hospital Clínico Universitario de Valladolid)

Fecha:	2019
Resumen:	Pairwise and network meta-analyses on the relationship between the efficacy of the use of statins with or without ezetimibe and reductions in low-density lipoprotein cholesterol (LDLc) and C-reactive protein (CRP) in patients with chronic kidney disease (CKD) are presented. In the pairwise meta-analysis, statins with or without ezetimibe were shown to be efficacious in reducing major adverse cardiovascular events (MACE) in patients with CKD and an estimated glomerular filtration rate (eGFR) of less than 60 ml/min/1. 73 m, in the context of both primary prevention [odds ratio (OR)/95% confidence interval (95% CI)/I/number of studies (n): 0. 50/0. 40-0. 64/0%/6] and primary/secondary prevention (0. 66/0. 57-0. 76/57%/18). However, in the Bayesian network meta-analysis, compared to the placebo, only atorvastatin 80 mg daily and atorvastatin and rosuvastatin at doses equivalent to simvastatin 20 mg daily reduced the odds of MACEs in this patient population. The network meta-analysis for LDLc and CRP treatment objectives also showed that, regardless of eGFR and excluding dialysis patients, the number of MACEs decreased in patients with CKD, with reductions in both LDLc and CRP of less than 50% (surface under the cumulative ranking (SUCRA)/heterogeneity (vague)/n: 0. 77/0. 14/3). The evaluation of the benefits of drugs may lead to individualized therapy for CKD patients: Cholesterol-lowering treatment for CKD patients with high levels of both LDLc and CRP is suggested.
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Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Publicado en:	Scientific reports, Vol. 9 Núm. 1 (january 2019) , p. 8951, ISSN 2045-2322

DOI: 10.1038/s41598-019-45431-5
PMID: 31222137

11 p, 2.4 MB

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