Proteinuria-Lowering Effects of Proprotein Convertase Subtilisin/Kexin Type 9 Inhibitors in Chronic Kidney Disease Patients: A Real-World Multicentric Study
Por:
Muñoz Ramos P, Gil Giraldo Y, Álvarez-Chiva V, Arroyo D, Sango Merino C, Moncho Francés F, Ocaña J, Reque J, Sánchez-Álvarez E, Górriz JL and Quiroga B
Publicada:
1 nov 2021
Ahead of Print:
5 nov 2021
Resumen:
Control of dyslipidemia in chronic kidney disease (CKD) is not always guaranteed with statins and/or ezetimibe. Proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) have opened up a new era in lipid control, but their effect on renal function and proteinuria in real life have not yet been evaluated. The aim of the present study was to analyze the evolution of renal function and proteinuria in a cohort of CKD patients treated with PCSK9i. This retrospective multicentric cohort study included CKD patients treated with PCSK9i. Baseline epidemiological data, comorbidities and laboratory findings (including estimated glomerular filtration rate [eGFR], proteinuria and lipid profile) were collected. The evolution of renal function, proteinuria and lipid profile was analyzed during the 1-year follow-up. The cohort included 76 patients (68% male, mean age 66 +/- 10 years). The mean baseline creatinine was 1.55 +/- 0.77 mg/dL, and the mean eGFR was 52 +/- 22 mL/min/1.73 m(2). Reductions in LDL-cholesterol, total cholesterol and triglycerides during the first month were 51 +/- 25%, 32 +/- 25% and 11 +/- 40%, respectively, levels that remained stable throughout the first year (p < 0.001 for LDL-cholesterol and total cholesterol trends and p = 0.002 for triglyceride trend). During follow-up, proteinuria improved from 57 (9-481) to 30 (7-520) mg/g (p = 0.021). In addition, eGFR remained stable, and no adverse events were reported. In our cohort, dyslipidemia treatment with PCSK9i was associated with decreased proteinuria in CKD patients, an effect that might be due to reduced lipid nephrotoxicity. Clinical trials are needed to further investigate whether this impact on proteinuria can significantly slow CKD progression in the long term.
Filiaciones:
Muñoz Ramos P:
Nephrology Department, Hospital Universitario de La Princesa, 28006 Madrid, Spain
Gil Giraldo Y:
Nephrology Department, Hospital Universitario de La Princesa, 28006 Madrid, Spain
Álvarez-Chiva V:
Nephrology Department, Hospital Universitario de La Princesa, 28006 Madrid, Spain
Arroyo D:
Nephrology Department, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
Sango Merino C:
Nephrology Department, Hospital de Cabueñes, 33394 Gijón, Spain
Moncho Francés F:
Nephrology Department, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain
Ocaña J:
Nephrology Department, Fundación Hospital de Alcorcón, 28922 Madrid, Spain
:
Nephrology Department, Hospital General de Castellón, 12004 Castelló de la Plana, Spain
Sánchez-Álvarez E:
Nephrology Department, Hospital de Cabueñes, 33394 Gijón, Spain
Górriz JL:
Nephrology Department, Hospital Clínico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain
Quiroga B:
Nephrology Department, Hospital Universitario de La Princesa, 28006 Madrid, Spain
gold, Green Published
|