Asociación de simvastatina con ezetimiba como alternativa terapéutica en el control lipídico de enfermos renales crónicos en estadio 3-4. Resultados a un año

Introduction

Maximizing the control of conventional risk factors should be crucial in patients with chronic kidney disease due to their high cardiovascular risk. Recent studies suggest that lipid control using the combination of a statin and ezetimibe may have benefits in this specific population.

Material and methods

From September-2011 to September-2014, 22 patients with chronic kidney disease, stage 3-4 who did not reach optimal lipid levels in monotherapy with statin were included in the study. Mean age 67 ± 8 years. Half of the patients were smokers, 68% were diabetic and all of them received hypertensive treatment.

Results

Baseline, 6 months and one year follow-up controls were performed. Total cholesterol mean baseline and at one year was 202 ± 39 mg/dl and 147 ± 38 (P=.001), LDL, HDL and triglycerides baseline and at one year were as follows respectively: 123 ± 27 vs. 73 ± 28 (P=.0005), 45 ± 12 vs. 49 ± 11 (P=n. s.) and 195 ± 104 vs. 131 ± 57 mg/dl (P=n.s.). The estimated glomerular filtration rate basal medium was 37 ± 14 ml/min and one year: 37 ± 13 ml/min (P=n.s.) and urinary albumine/creatinine ratio, UA/Cr. was basal and one year: 679 vs. 523 mg/g (P=n.s.).

Conclusions

The combination of simvastatin plus ezetimibe in CKD patients appears to be effective in lipid control at least in this follow-up period. No serious side effects associated have been observed. Demonstrating a reduction in cardiovascular risk associated with greater control of lipid levels requires a longer period of monitoring.