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Randomized Controlled Trial
, 40 (1), 700-709

Effect of Atorvastatin on Iron Metabolism Regulation in Patients With Chronic Kidney Disease - A Randomized Double Blind Crossover Study

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Randomized Controlled Trial

Effect of Atorvastatin on Iron Metabolism Regulation in Patients With Chronic Kidney Disease - A Randomized Double Blind Crossover Study

Anna Masajtis-Zagajewska et al. Ren Fail.

Abstract

Introduction: To determine the effect of 6-month administration of atorvastatin on hepcidin and hemojuvelin levels, inflammatory parameters and iron metabolism in patients with chronic kidney disease (CKD) stages 3 and 4.

Methods: Thirty six statin- and erythropoiesis-stimulating agent-naive patients with CKD stages 3 and 4 and LDL cholesterol ≥100 mg/dl received atorvastatin or placebo for two 6-month periods in a double blind, randomized crossover study. Hepcidin, hemojuvelin, hsCRP, IL-6, hemoglobin, red blood cell distribution width, iron, total iron binding capacity (TIBC), and unsaturated iron binding capacity (UIBC) were measured before and after each treatment period.

Results: Hepcidin decreased (from 102 [307] to 63 [170] pg/ml (p > .001)) in the course of statin therapy but remained unchanged after placebo administration (173 [256] to 153 [204] pg/ml, respectively). Hemojuvelin did not change after either part of the study. Both IL-6 and hsCRP decreased following statin therapy (from 8.7 [12.0] to 8.1 [13.9] pg/ml; p = .04 and from 4.7 [4.0] to 4.0 [3.6] mg/l; p = .4, respectively), but did not change after placebo administration. Blood hemoglobin increased slightly but significantly after 6-month statin therapy (from 11.6 ± 1.6 to 11.9 ± 1.5 g/dl, p = .002), and was unchanged after placebo treatment. TIBC and UIBC increased significantly after 6-month statin therapy, and serum iron also tended to increase. The change of eGFR during the study did not differ between the two treatment periods.

Conclusions: Statin may have a small but potentially beneficial effect on serum hepcidin, which may lead to improvement of anemia control in CKD patients.

Keywords: Hepcidin; chronic kidney disease; hemojuvelin; inflammation; iron metabolism.

Figures

Figure 1.
Figure 1.
Study design.
Figure 2.
Figure 2.
Changes of UIBC, TIBC, hepcidin, hemoglobin, MCHC, and IL-6 after placebo and atorvastatin treatment.

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