Abstract: TH-PO737

Proteinuria and Cholesterol Reduction Are Independently Associated with Less Renal Function Decline in Statin Treated Patients: A Post-Hoc Analysis of the PLANET Trials

Session Information

Category: Diabetes

  • 502 Diabetes Mellitus and Obesity: Clinical

Authors

  • Idzerda, Nienke, University Medical Center Groningen, Groningen, Netherlands
  • Pena, Michelle, University Medical Center Groningen, Groningen, Netherlands
  • Parving, Hans-Henrik, Rigshospitalet, Copenhagen, Denmark
  • de Zeeuw, Dick, University Medical Center Groningen, Groningen, Netherlands
  • Lambers Heerspink, Hiddo Jan, University Medical Center Groningen, Groningen, Netherlands
Background

Statins have shown multiple effects on different renal risk factors such as lowering of cholesterol (TC) and lowering of proteinuria (UPCR). These effects seem to vary between individuals. We questioned whether the changes in UPCR and TC run in parallel within one individual, and secondly, how this contributes to renal outcome (eGFR decline).

Methods

The PLANET studies studied the effects of a 52-week treatment with atorvastatin and rosuvastatin on UPCR and renal function (eGFR) in proteinuric patients. In this post-hoc analysis, we first assessed the individual variability in UPCR and TC response (0-14 weeks). UPCR response was defined as a decrease in UPCR of >0% and TC response as decrease in TC of >100 mg/dl (2.59 mmol/l) from baseline. Second, we determined whether these responses were predictive of eGFR decline during subsequent 9 months follow-up.

Results

UPCR and TC response varied between patients: mean UPCR response was -1.3% (5th – 95th percentile -59.9, 141.8), mean TC response was -93.9 mg/dl (-169.1, -26.9). Out of 471 patients, 123 (26.1%) showed a response in UPCR but not in TC, and 96 (20.4%) showed a response in TC but not in UPCR. eGFR (ml/min/1.73m2) decreased non-significantly from baseline in both UPCR responders (0.4; 95%CI [-1.6, 0.8]; p=0.54) and TC responders (0.4; [-1.8, 1.1]; p=0.62), whereas UPCR and TC non-responders showed a significant decline in eGFR (1.8; [0.6, 3.0]; p=0.004 and 1.7; [0.5, 2.9]; p=0.006, respectively). A lack of response in both parameters resulted in the fastest rate of eGFR decline (2.1; [0.5, 3.7]; p=0.01). These findings were not different for rosuvastatin or atorvastatin.

Conclusion

TC and UPCR response to statins vary between individuals and do not run in parallel within an individual. The initial fall in cholesterol and proteinuria are independently associated with a reduction in the long term eGFR decline. This highlights the importance of both monitoring TC and UPCR after initiating statin therapy.

Funding

  • Commercial Support