Effectiveness of statins on haemodialysis patients with concomitant peripheral arterial disease – a narrative review

Authors

  • Celso Nunes Angiology and Vascular Surgery Department, Centro Hospitalar e Universitário de Coimbra, Portugal
  • Juliana Sousa Angiology and Vascular Surgery Department, Centro Hospitalar e Universitário de Coimbra, Portugal
  • Vânia Oliveira Angiology and Vascular Surgery Department, Centro Hospitalar e Universitário de Coimbra, Portugal
  • Eduardo Silva Angiology and Vascular Surgery Department, Centro Hospitalar e Universitário de Coimbra, Portugal https://orcid.org/0000-0002-5202-9070
  • Leonor Baldaia Angiology and Vascular Surgery Department, Centro Hospitalar e Universitário de Coimbra, Portugal https://orcid.org/0000-0001-9979-8646
  • Miguel Silva Angiology and Vascular Surgery Department, Centro Hospitalar e Universitário de Coimbra, Portugal https://orcid.org/0000-0002-6881-7514
  • Luis Orelhas Angiology and Vascular Surgery Department, Centro Hospitalar e Universitário de Coimbra, Portugal https://orcid.org/0000-0003-2597-7507
  • Manuel Fonseca Angiology and Vascular Surgery Department, Centro Hospitalar e Universitário de Coimbra, Portugal

DOI:

https://doi.org/10.48750/acv.552

Keywords:

Statin, Hemodialysis, peripheral arterial disease, patient outcomes

Abstract

INTRODUCTION: The use of statins in hemodialysis patients is a topic of ongoing research and debate. Patients with chronic kidney disease on hemodialysis constitute a large proportion of patients treated in the vascular surgery field. Clinical data of the protective statin effect on this group is scarce and conflicting results exist regarding cardiovascular, cerebrovascular and limb outcomes.
METHODS: We performed a thorough electronic search of the literature using PubMed and Embase databases to understand the relationship between statin effect and cardiovascular, limb outcomes and cerebrovascular outcomes. A narrative review was constructed, based on the obtained literature.
RESULTS: Although the use of statins in hemodialysis patients may provide cardiovascular benefits, the optimal dosage and safety profile of these medications in this population remain uncertain. A carefully evaluation of the risks and benefits of statins should be made based on each patient's specific requirements and circumstances.
CONCLUSION: The role of statins for patients with peripheral arterial disease who are on hemodialysis remains unclear. Further analyses should focus on this subgroup of dialysis patients, who are becoming more prevalent on the vascular surgery departments, allowing for an optimized treatment with better patient outcomes.

Downloads

Download data is not yet available.

References

Barylski M, Nikfar S, Mikhailidis DP, Toth PP, Salari P, Ray KK, et al. Lipid and Blood Pressure Meta-Analysis Collaboration Group. Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy--a meta-analysis of 11 randomized controlled trials involving 21,295 participants. Pharmacol Res. 2013;72:35-44.

Nikolic D, Nikfar S, Salari P, Rizzo M, Ray KK, Pencina MJ, et al. Lipid and Blood Pressure Meta-Analysis Collaboration Group. Effects of statins on lipid profile in chronic kidney disease patients: a meta-analysis of randomized controlled trials. Curr Med Res Opin. 2013;29:435-51.

Palmer SC, Navaneethan SD, Craig JC, Johnson DW, Perkovic V, Nigwekar SU. HMG CoA reductase inhibitors (statins) for dialysis patients. Cochrane Database Syst Rev. 2013;(9):CD004289

Wang W, Zhang B. Statins for the prevention of stroke: a meta-analysis of randomized controlled trials. PLoS One. 2014;9:e92388.

Sun L, Zou L, Chen M, Liu B. Meta-analysis of statin therapy in maintenance dialysis patients. Ren Fail. 2015;37:1149-56.

Wang J, Chen D, Li DB, Yu X, Shi GB. Comparison of the efficacy and safety of intensive-dose and standard-dose statin treatment for stroke prevention: A meta-analysis. Medicine (Baltimore). 2016;95:e4950.

Cholesterol Treatment Trialists' (CTT) Collaboration; Herrington WG, Emberson J, Mihaylova B, Blackwell L, Reith C, Solbu MD, et al. Impact of renal function on the effects of LDL cholesterol lowering with statin-based regimens: a meta-analysis of individual participant data from 28 randomised trials. Lancet Diabetes Endocrinol. 2016;4:829-39.

Krane V, Schmidt KR, Gutjahr-Lengsfeld LJ, Mann JF, März W, Swoboda F, et al. 4D Study Investigators (the German Diabetes and Dialysis Study Investigators). Long-term effects following 4 years of randomized treatment with atorvastatin in patients with type 2 diabetes mellitus on hemodialysis. Kidney Int. 2016;89:1380-7

Messow CM, Isles C. Meta-analysis of statins in chronic kidney disease: who benefits? QJM. 2017;110:493-500

Ghayda RA, Lee JY, Yang JW, Han CH, Jeong GH, Yoon S, et al. The effect of statins on all-cause and cardiovascular mortality in patients with nondialysis chronic kidney disease, patients on dialysis, and kidney transplanted recipients: an umbrella review of meta-analyses. Eur Rev Med Pharmacol Sci. 2021;25:2696-710

Lo HY, Lin YS, Lin DS, Lee JK, Chen WJ. Association of Statin Therapy With Major Adverse Cardiovascular and Limb Outcomes in Patients With Endstage Kidney Disease and Peripheral Artery Disease Receiving Maintenance Dialysis. JAMA Netw Open. 2022;5:e2229706.

Wheeler DC, London GM, Parfrey PS, Block GA, Correa-Rotter R, Dehmel B, et al. EValuation Of Cinacalcet HCl Therapy to Lower CardioVascular Events (EVOLVE) Trial Investigators: Effects of cinacalcet on atherosclerotic and nonatherosclerotic cardiovascular events in patients receiving hemodialysis: The Evaluation Of Cinacalcet HCl Therapy to Lower CardioVascular Events (EVOLVE) trial. J Am Heart Assoc. 2015;4:e000570.

Caluwé R, Pyfferoen L, De Boeck K, De Vriese AS: The effects of vitamin K supplementation and vitamin K antagonists on progression of vascular calcification: Ongoing randomized controlled trials. Clin Kidney J. 2016;9:273–9

Sukkar L, Talbot B, Jun M, Dempsey E, Walker R, Hooi L, et al. Protocol for the Study of Heart and Renal Protection-Extended Review: Additional 5-Year Follow-up of the Australian, New Zealand, and Malaysian SHARP Cohort. Can J Kidney Health Dis. 2019;6:2054358119879896.

Suh D, Amendola MF, Reeves M, Wolfe L, Posner M, Davis R. Statins Protect against Thrombosis of Cannulated Radiocephalic Fistulas in Diabetic Patients. Ann Vasc Surg. 2021;75:280-6

Chang HH, Chang YK, Lu CW, Huang CT, Chien CT, Hung KY. Statins Improve Long Term Patency of Arteriovenous Fistula for Hemodialysis. Sci Rep. 2016;6:22197.

Kang MH, Kim W, Kim JS, Jeong KH, Jeong MH, Hwang JY, et al. Hydrophilic Versus Lipophilic Statin Treatments in Patients With Renal Impairment After Acute Myocardial Infarction. J Am Heart Assoc. 2022;11:e024649.

Climent E, Benaiges D, Pedro-Botet J. Hydrophilic or Lipophilic Statins? Front Cardiovasc Med. 2021;8:687585.

Downloads

Published

2024-03-03

How to Cite

1.
Nunes C, Sousa J, Oliveira V, Silva E, Baldaia L, Silva M, Orelhas L, Fonseca M. Effectiveness of statins on haemodialysis patients with concomitant peripheral arterial disease – a narrative review. Angiol Cir Vasc [Internet]. 2024 Mar. 3 [cited 2024 Dec. 26];19(4):218-20. Available from: https://acvjournal.com/index.php/acv/article/view/552

Issue

Section

Review Article