HMG-CoA reductase inhibitors for the prevention of nephropathy

OBJECTIVE: To evaluate the literature to determine whether hydroxymethylglutaryl coenzyme A reductase inhibitors are effective for the prevention of nephropathy. DATA SOURCES: MEDLINE (1966-April 2003) and International Pharmaceutical Abstracts (1970-April 2003), as well as bibliographic searches, were conducted. DATA SYNTHESIS: Although the statins are widely used for the prevention of coronary heart disease, non-lipid-lowering effects are also being investigated, namely their potential role in the prevention of nephropathy. Five trials of the statins used in this manner are reviewed, most of which included patients with dyslipidemias, making it difficult to determine whether the renoprotective effects were independent of the lipid-lowering effects. CONCLUSIONS: Adequate evidence does not currently exist to support the widespread use of statins as alternatives to strategies known to prevent the progression of renal disease, but statins may be used to complement other therapies in patients with additional indications.