Improvement of clinical outcomes in patients undergoing peritoneal dialysis using hydroxymethylglutaryl-CoA reductase inhibitors: A systematic review and meta-analysis. Issue 2 (4th November 2022)

• Record Type: Journal Article
• Authors: Lee, Dan-Ying; Huang, Chi-Jung; Yeh, Wan-Yu; Sung, Shih-Hsien; Chen, Chen-Huan; Cheng, Hao-Min
• Is Part Of: Journal of the Chinese Medical Association. Volume 86:Issue 2(2023)
• Page Start: 155
• Page End: 165
• Publication Date: 2022-11-04
• Subjects: All-cause mortality -- Cardiovascular disease -- Meta-analysis -- Peritoneal dialysis -- Statin; Medicine -- Periodicals; 610.5
• DOI: 10.1097/JCMA.0000000000000840
• Languages: English
• ISSNs: 1726-4901

Abstract

Abstract : Background: It is unclear whether hydroxymethylglutaryl-CoA reductase inhibitor (statin) therapy decreases the risk of mortality and cardiovascular disease (CVD) in patients undergoing peritoneal dialysis (PD). Methods: We performed a literature search of PubMed, Cochrane Library, Embase, and other databases for research publications up to June 2022. The outcomes of interest were fatal and nonfatal CVDs, all-cause mortality, and changes in the biochemical profiles. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled and synthesized using a random-effects model. The certainty of the evidence was determined using Grading of Recommendations, Assessment, Development, and Evaluation. Results: Nine studies, including 2, 933 patients undergoing PD, were included. Among them, three studies, including 2, 099 patients, reported all-cause mortality, and three, including 1, 571 patients, reported CVDs. In these patients, pooling results of two observational studies (very low-certainty evidence) showed that statin therapy significantly reduced CVDs (HR = 0.67; 95% CI = 0.54–0.84; p = 0.0004). Moreover, statin therapy was associated with significantly reduced low-density lipoprotein cholesterol, total cholesterol, and C-reactive protein levels (very low certainty of evidence). However, the effects of statin therapy on triglyceride, high-density lipoprotein, and albumin levels were not statistically significant. Conclusion: Although statin therapy was associated with significantly reduced low-density lipoprotein cholesterol, total cholesterol, and C-reactive protein levels, the probable beneficial effect of statins on CVD risk in patients undergoing PD could not be concluded firmly. Additional high-quality studies are required to assess the potential beneficial effects of statin therapy in PD patients.