Abstract
Background: Several studies have demonstrated the improvement in serum lipoproteins by statins
in patients with Chronic Kidney Diseases (CKDs), including End-Stage Renal Disease (ESRD). However, the
results of these studies are inconclusive.
Aim: We aimed to systematically investigate the effect of statins on lipid profiles of patients with CKD by performing
a meta-analysis of Randomized Controlled Trials (RCTs).
Methods: Major electronic databases (Scopus, MEDLINE/PubMed, and ISI Web of Science) were searched
from inception to August, 2023, to find randomized controlled trials (RCTs) evaluating the effect of different
statins on serum lipoproteins in CKD patients. Weighted Mean Difference (WMD) with 95% Confidence Intervals
(CI) was used to estimate the effect size. Trial Sequential Analysis (TSA) was performed to confirm the
robustness of the evidence.
Results: A total of 18 publications were identified. It was found that statins reduced serum levels of Low-Density
Lipoprotein (LDL)-C (WMD = -27.81 mg/dl, 95% CI = -34.47 to -21.15, P < 0.001) and total cholesterol
(WMD = -25.44 mg/dl, 95% CI = -34.71 to -16.18, P < 0.001) in patients with CKD compared to the control
group. Nonetheless, the effect of statins on High-Density Lipoprotein (HDL)-C (WMD = 0.57 mg/dl, 95% CI
= -0.71 to 1.85, P = 0.38) and Triglyceride (TG) (WMD = -9.08 mg/dl, 95% CI = -22.22 to 2.06, P = 0.11)
was not statistically significant. The results of TSA confirmed the robustness of the evidence and were consistent
with the pooled effect size. The findings of subgroup analysis and time response analysis were also significant.
Conclusion: It was found that statin therapy reduced the levels of LDL-C and total cholesterol in patients with
CKD.
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