Toru Sanai, Takashi Ono and Toma Fukumitsu
Objective: Risk factors development are similar to those implicated in cardiovascular diseases (cardiac failure, ischemic heart disease, and peripheral arterial disease), hypertension, diabetes mellitus, and dyslipidemia in hemodialysis (HD). Therefore, it is necessary to optimize the treatment (dyslipidemia) of these patients.
Methods: We examined changes in physiological parameters, renal function markers and lipid profiles induced by statins, such as pravastatin sodium (water-soluble, PS), atorvastatin calcium hydrate (fat-soluble, ACH) and pitavastatin calcium (fat-soluble, PC).
Results: Dyslipidemia with medication was observed in 34 (24.8%) of the 137 HD patients. The therapeutic statins used for dyslipidemia were as follows: PS was used in the nine patients, ACH was used in 11 patients and PC was used in nine HD patients. The waist circumference and body mass index were more significantly increased in the patients treated with ACH (90.9 ± 10.5 cm [mean ± standard deviation], 24.8 ± 2.9 kg/m2) than in the patients treated with PS (79.9 ± 10.3 cm, 21.0 ± 2.9 kg/m2; P < 0.05). While the serum triglyceride levels in the PS group were 103 ± 36 mg/dl, those in the ACH group were 164 ± 75 mg/dl (P < 0.05). In addition, the serum whole parathyroid hormone levels were significantly higher in the ACH group (151 ± 102 pg/ml) than in the PS group (55 ± 32 pg/ml, P < 0.05). There were no differences between the PS and the PC groups in any of the laboratory data, except for the serum creatinine levels.
Conclusion: Waist circumference, body mass index and the serum triglyceride levels were increased in the ACH HD patients. Interestingly, the serum whole PTH levels were found to be significant in the ESRD patients treated with ACH. Based on our results, PC may be an ideal statin for treating HD patients.
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