Nephrol Dial Transplant (2002) 17: 798-802
© 2002 European Renal Association-European Dialysis and Transplant Association
Effect of cerivastatin on proteinuria and urinary podocytes in patients with chronic glomerulonephritis
1 Department of Medicine, Misato Junshin Hospital, Saitama, 2 Department of Medicine, National Rehabilitation Center, Saitama, 3 Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama and 4 Department of Medicine, Koto Hospital, Tokyo, Japan
Background. We previously reported urinary podocytes to be a marker of glomerular injury. The aim of the present study was to determine whether cerivastatin, a newly developed, potent synthetic statin, affects proteinuria and urinary podocyte excretion in patients with chronic glomerulonephritis (CGN).
Methods. We randomly assigned 40 normotensive hypercholesterolemic patients with CGN to receive either cerivastatin 0.15 mg/day (n=20) or placebo (n=20). Subjects comprised 24 men and 16 women, with a mean age of 40.8±14.4 years; 27 had IgA nephropathy and 13 had non-IgA proliferative glomerulonephritis. Treatment was continued for 6 months. Plasma total cholesterol, HDL-cholesterol, LDL-cholesterol and triglycerides, urinary protein excretion and the number of podocytes were measured before treatment and at 3 and 6 months after treatment.
Results. After 6 months, a significant reduction in total cholesterol (P<0.001), LDL-cholesterol (P<0.001) and triglycerides (P<0.05), and a significant increase in HDL-cholesterol (P<0.001) were observed in the group treated with cerivastatin. Urinary protein excretion decreased from 1.8±0.6 to 0.8±0.4 g/day, (P<0.01) in this group, and urinary podocyte excretion decreased from 1.6±0.6 to 0.9±0.4 cells/ml (P<0.01). However, placebo showed little effect on these lipid levels, urinary protein excretion and urinary podocyte excretion. The differences between the cerivastatin group and the placebo group were significant (cholesterol, P<0.001; LDL-cholesterol, P<0.001; triglycerides, P<0.05; HDL-cholesterol, P<0.001; urinary protein, P<0.01; and urinary podocytes, P<0.01).
Conclusion. Statins such as cerivastatin may be beneficial for restoration of injured podocytes in patients with CGN and hypercholesterolaemia.
Keywords: cerivastatin; glomerular epithelial cells; hypercholesterolaemia; podocalyxin
Correspondence and offprint requests to: Hikaru Koide, Department of Medicine, Koto Hospital, 6-8-5 Ojima, Koto-ku, Tokyo 136-0072, Japan. Email: hkoide{at}koto\|[hyphen]\|hospital.or.jp
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