The effect of statins on renal outcomes in patients with diabetic kidney disease: A systematic review and meta-analysis
The effects of statins on renal outcomes in patients with diabetic kidney disease were conflicting. The aim of the study was to investigate whether statins treatment could affect renal outcomes (albuminuria or proteinuria, estimated glomerular filtration rate [eGFR]) for diabetic kidney disease patients. We searched the PubMed, OVID (including MEDLINE and EMBASE), Web of Science and the Cochrane Central Register of Controlled Trials. Randomized controlled trials evaluating the efficacy of statins in diabetic kidney disease patients were selected. The main outcomes were albuminuria (or proteinuria). Secondary outcomes were levels of eGFR. Two authors independently assessed study quality and extracted the information from enrolled trials. Eleven randomized controlled trials with a total number of 543 diabetic kidney disease participants were included in our study. The overall estimates showed that statins statistically reduced albuminuria (standardized mean differences −0.71, 95% CI −1.20 to −0.23, P = .004), though marked heterogeneity was found within studies. However, the analysis results indicated that statins could not reduce overt proteinuria (standardized mean differences −0.14, 95% CI −0.53 to 0.26, P = .49) or slow the rate of reduction in eGFR (standardized mean differences 0.06, 95% CI −0.14 to 0.26, P = .53). In general, our study demonstrated that statins might have beneficial effects on reducing albuminuria in diabetic kidney disease patients. However, there was no strong evidence that the same intervention had an effect on overt proteinuria or eGFR outcomes in these patients.