Cholesterol drug benefits kidney patients: Study

Patients receiving the daily pill, a combination of simvastatin and ezetimibe, had one-sixth fewer heart attacks, strokes or operations to unblock arteries than those receiving a placebo 'dummy' pill.

The study findings were reported at an American Society of Nephrology conference in Denver, USA, a university release said.

Chronic kidney disease is very common, affecting up to one in twenty of the middle-aged population, and substantially more of those who are older.

Although people with chronic kidney disease are known to have an increased risk of a stroke or heart attack, it has been very unclear what treatments could prevent these conditions in this group of patients.

Dr Martin Landray, co-principal investigator at Oxford's Clinical Trial Service Unit, said, "Over the past couple of decades, we have increasingly recognized that chronic kidney disease is associated with a high risk of cardiovascular complications, and have realised that kidney disease is common. But we have failed so far to identify any treatments that are effective in reducing that risk".

The Study of Heart and Renal Protection (SHARP) involved almost 9,500 volunteers aged 40 or over with chronic kidney disease.

Those taking part came from 380 hospitals in 18 countries and had lost more than 50 per cent of their normal kidney function, with a third of them requiring dialysis treatment.
None had had a previous heart attack or needed bypass surgery or 'stents' to unblock their heart arteries.

Volunteers in this double-blind placebo-controlled trial were randomly allocated to take either cholesterol-lowering therapy with a tablet containing ezetimibe 10mg daily and simvastatin 20mg daily, or matching placebo tablets.

Study treatment and follow-up continued for an average of 5 years. In that time, 11.3 per cent of patients (526 out of 4650) taking the drug had a heart attack, stroke or needed an operation to unblock an artery compared with 13.4 per cent (619 of 4620) in the placebo group.

That is a reduction of a sixth in the likelihood of these events. Professor Colin Baigent of the Clinical Trial Service Unit at Oxford University, the trial's principal investigator, said, "This is excellent news for patients who have kidney disease. It was already known that cholesterol-lowering could reduce the risk of heart attacks, strokes and the need for surgery to unblock arteries in people with normal kidney function".

But this trial now shows that cholesterol-lowering has similar effects in people with chronic kidney disease, irrespective of the severity of their illness.

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