Anti-inflammatory effects of 3-hydroxy-3-methylglutaryl coenzyme a reductase inhibitors (statins) in peritoneal dialysis patients.

Objective: Elevated C-reactive protein (CRP) level is an independent predictor of all-cause and cardiovascular mortality in peritoneal dialysis (PD) patients. Statins have been demonstrated to have anti-inflammatory properties by virtue of their CRP lowering effects in hemodialysis patients. However, whether statins have an anti-inflammatory effect in PD patients is unknown.

Design: All prevalent PD patients at our center were reviewed. Eligible (257) patients were categorized into 2 groups: those on statin therapy (n = 137) and those not on statins (n = 120). Data were abstracted for hemoglobin, albumin, phosphates, cholesterol, CRP, Kt/V, and erythropoietin dose, along with relevant clinical data.

Results: The two groups had similar concentrations of hemoglobin, albumin, and phosphates. They were also matched for dialysis adequacy and duration of dialysis but the statin group patients were older (57 +/- 13 vs 52 +/- 17 years, p = 0.01). Serum cholesterol was lower in the statin group (4.74 +/- 1.05 vs 5.02 +/- 1.17 mmol/L, p < 0.05). Single-point (14 +/- 13 vs 19 +/- 18 mg/L, p < 0.02) and serially measured CRP (9 +/- 7.4 vs 12 +/- 10 mg/L, p < 0.02) levels were significantly lower in the statin group despite increased comorbidity (0.84 vs 0.54, p < 0.02) and greater incidence of diabetes mellitus (52% vs 25%, p < 0.01).

Conclusion: Statin therapy is associated with low single-point and serially measured CRP levels in PD patients, thereby suggesting that their anti-inflammatory properties persist in PD. These data have implications for considering statin therapy in PD patients as an anti-inflammatory agent in addition to a cholesterol lowering drug.