Short-term safety and efficacy of escalating doses of atorvastatin for dyslipidemia in children with predialysis chronic kidney disease stage 2–5.
Background: Dyslipidemia is a potentially modifiable risk factor in patients with chronic kidney disease (CKD). Information on the safety and efficacy of statins in pediatric CKD is limited. Methods: Patients with CKD stage 2–5 and aged 5–18 years with low-density lipoprotein cholesterol (LDL-C) > 1...
| Published in: | Pediatric Nephrology Vol. 38; no. 8; pp. 2763 - 2771 |
|---|---|
| Main Authors: | , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Springer Nature
Aug2023
|
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=169702900&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 169702900 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 0931041X EF1 jtl: Pediatric Nephrology issn: 0931041X maglogo: N pubinfo: dt: Aug2023 vid: 38 iid: 8 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 169702900 161848022 169702900 169702900 10.1007/s00467-023-05887-0 169702900 ppf: 2763 ppct: 8 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Short-term safety and efficacy of escalating doses of atorvastatin for dyslipidemia in children with predialysis chronic kidney disease stage 2–5. aug: au: Ramesh, Punitha Lakxmi Khandelwal, Priyanka Lakshmy, R. Sinha, Aditi Bagga, Arvind Hari, Pankaj affil: Division of Nephrology, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India sug: subj: Kidney Failure, Chronic Therapy Severity of Illness Dialysis In Infancy and Childhood Hyperlipidemia Drug Therapy Atorvastatin Administration and Dosage Patient Safety Drug Efficacy Treatment Outcomes Human Child Male Female Lipoproteins, LDL Blood Lipoproteins, HDL Blood Lipids Blood Odds Ratio Confidence Intervals Descriptive Statistics Child: 6-12 years Male Female ab: Background: Dyslipidemia is a potentially modifiable risk factor in patients with chronic kidney disease (CKD). Information on the safety and efficacy of statins in pediatric CKD is limited. Methods: Patients with CKD stage 2–5 and aged 5–18 years with low-density lipoprotein cholesterol (LDL-C) > 130 mg/dL and/or non-high-density lipoprotein cholesterol (non-HDL-C) > 145 mg/dL were enrolled from September 2019 to February 2021. All patients were administered atorvastatin 10 mg/day, which was escalated to 20 mg/day if LDL-C remained > 100 mg/dL and/or non-HDL-C > 120 mg/dL at 12 weeks. Proportion of patients achieving target lipid levels (LDL-C ≤ 100 mg/dL and non-HDL-C ≤ 120 mg/dL) and adverse events were assessed at 24 weeks. Results: Of 31 patients enrolled, target lipid levels were achieved in 45.2% (95% CI 27.8–63.7%) at 24 weeks; 22 patients required dose escalation to 20 mg at 12 weeks. There was no difference in median lipid level reduction with 10 (n = 9) versus 20 mg/day (n = 22, P = 0.3). Higher baseline LDL-C (OR 1.06, 95% CI 1.00–1.11) and older age (OR 36.5, 95% CI 2.57–519.14) were independent predictors of failure to achieve target lipid levels with 10 mg/day atorvastatin. None had persistent rise in AST/ALT > 3 times upper normal limit (UNL) or CPK > 10 times UNL. No differences were noted in adverse events due to atorvastatin 10 or 20 mg/day. Conclusion: Atorvastatin (10–20 mg/day) administered for 24 weeks was safe and effectively reduced LDL-C and non-HDL-C in children with CKD stages 2–5. Patients with higher baseline LDL-C required higher doses to achieve the target. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
|---|