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Lipid-modifying drugs may decrease all-cause, cardiovascular-specific mortality in patients on peritoneal dialysis, study data suggest

Monday, November 12 2007 | Comments
Evidence Grade 0 What's This?
Lipid-modifying drug therapy may be associated with improved clinical outcomes among patients on peritoneal dialysis, according to study findings.

Researchers conducted a secondary analysis of a retrospective cohort study, known as the Dialysis Morbidity and Mortality Wave 2 study, which included 1,053 incident patients on peritoneal dialysis to evaluate the effect of lipid-lowering therapy on clinical outcomes in these patients.

Results showed that, overall, patients who used lipid-modifying drugs had decreased all-cause (HR, 0.74; 95% CI, 0.56-0.98) and cardiovascular-specific (HR, 0.67; 95% CI, 0.47-0.95) mortality relative to those who did not use lipid-modifying drugs.

In a subgroup analysis, patients with serum total cholesterol levels from 226 mg/dL to 275 mg/dL, use of lipid-modifying drugs was associated with significantly decreased risk of all-cause (HR, 0.46; 95% CI, 0.22-0.95; P=.04) and cardiovascular-specific (HR, 0.31; 95% CI, 0.11-0.85; P=.02) mortality.

In the subgroup of patients with serum total cholesterol levels >275 mg/dL, use of lipid-modifying drugs was associated with significantly reduced risk of all-cause (HR, 0.27; 95% CI, 0.09-0.80; P=.02) but not cardiovascular-specific (HR, 0.57; 95% CI, 0.17-2.00; P=.4) mortality.

Additionally, use of lipid-modifying drugs was associated with decreased cardiovascular-specific mortality  (HR, 0.64; 95% CI, 0.41-0.99; P=.04) as well as decreased risk of all-cause (HR, 0.65; 95% CI, 0.45-0.94; P=.02) among patients with diabetes and with cardiovascular-specific (HR, 0.55; 95% CI, 0.35-0.87; P=.02) mortality in patients with Charlson Comorbidity Index scores >2.

"In conclusion, the present analysis provides support for the use of statins in the management of peritoneal dialysis patients with hypercholesterolemia with diabetes or high comorbidity," the authors wrote. (Goldfarb-Rumyantzev AS, et al. Am J Kidney Dis 2007;50:791-802.)

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