Effects of Atorvastatin on Kidney Outcomes and Cardiovascular Disease in Patients With Diabetes: An Analysis From the Collaborative Atorvastatin Diabetes Study (CARDS)

Colhoun, Helen M.; Betteridge, D. John; Durrington, Paul N.; Hitman, Graham A.; Neil, H. Andrew W.; Livingstone, Shona J.; Charlton-Menys, Valentine; DeMicco, David A.; Fuller, John H.

doi:10.1053/j.ajkd.2009.03.022

Cited by 255Chronic Kidney Disease and DiabetesLipoproteins and Cardiovascular HealthDiabetes, Cardiovascular Risks, and Lipoproteins

Effects of Atorvastatin on Kidney Outcomes and Cardiovascular Disease in Patients With Diabetes: An Analysis From the Collaborative Atorvastatin Diabetes Study (CARDS)

Colhoun, Helen M., Betteridge, D. John, Durrington, Paul N., Hitman, Graham A., Neil, H. Andrew W., Livingstone, Shona J., Charlton-Menys, Valentine, DeMicco, David A. +1 more·2009·American Journal of Kidney Diseases

DOI 10.1053/j.ajkd.2009.03.022

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Abstract

Background We examined whether atorvastatin affects diabetic kidney disease and whether the effect of atorvastatin on cardiovascular disease (CVD) varies by kidney status in patients with diabetes. Study design The Collaborative Atorvastatin Diabetes Study (CARDS) randomized placebo-controlled trial. Setting & participants Patients with type 2 diabetes and no prior CVD (n = 2,838). Intervention Random allocation to atorvastatin, 10 mg/d, or placebo, with a median follow-up of 3.9 years. Outcomes Estimated glomerular filtration rate (eGFR), albuminuria, CVD. Measurements Baseline and follow-up GFRs were estimated by using the Modification of Diet in Renal Disease Study equation. Urinary albumin-creatinine ratio was measured on spot urine samples. Results At baseline, 34% of patients had an eGFR of 30 to 60 mL/min/1.73 m(2). Atorvastatin treatment was associated with a modest improvement in annual change in eGFR (net, 0.18 mL/min/1.73 m(2)/y; 95% confidence interval [CI], 0.04 to 0.32; P = 0.01) that was most apparent in those with albuminuria (net improvement, 0.38 mL/min/1.73 m(2)/y; P = 0.03). At baseline, 21.5% of patients had albuminuria and an additional 6.8% developed albuminuria during follow-up. Atorvastatin did not influence the incidence of albuminuria (hazard ratio, 1.49; 95% CI, 0.73 to 3.04; P = 0.3) or regression to normoalbuminuria (hazard ratio, 1.19; 95% CI, 0.57 to 2.49; P = 0.6). In 970 patients with a moderately decreased eGFR of 30 to 60 mL/min/1.73 m(2),…

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Statin trials have not consistently shown renoprotective effects despite moderate triacylglycerol reduction.
“As statin trials have not consistently shown renoprotective effects, despite moderate triacylglycerol reduction [28][29][30]”
From Effects of fenofibrate on renal function in patients with type 2 diabetes mellitus: the Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) Study (2011) · cites this paper as [29]

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Authors: Colhoun, H. M., Betteridge, D. J., Durrington, P. N., Hitman, G. A., Neil, H. A. W., Livingstone, S. J., Charlton-Menys, V., DeMicco, D. A., & Fuller, J. H.
Affiliations: University of Dundee (GB)
University College Hospital (GB)
University of Manchester (GB)
Queen Mary University of London (GB)
University of Oxford (GB)
Pfizer (United States) (US)
The Royal Free Hospital (GB)
Corresponding author: Colhoun, Helen M.
ORCID: Colhoun, Helen M.
Durrington, Paul N.
Hitman, Graham A.
Livingstone, Shona J.
DeMicco, David A.
Venue: American Journal of Kidney Diseases
Publisher: Elsevier BV
Published: 2009-11
Volume: 54
Issue: 5
Pages: 810-819
ISSN: 0272-6386 (ISSN-L)
DOI: 10.1053/j.ajkd.2009.03.022
OpenAlex: W2029977823
Cited by: 255
References: 25
Citations by year: 2026: 3 · 2025: 3 · 2024: 10 · 2023: 7 · 2022: 8 · 2021: 15 · 2020: 13 · 2019: 10 · 2018: 10 · 2017: 11 · 2016: 18 · 2015: 19 · 2014: 44 · 2013: 20 · 2012: 32
FWCI: 14.59
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
Locations: American Journal of Kidney Diseases (publishedVersion)
PubMed (publishedVersion)
Discovery Research Portal (University of Dundee) (publishedVersion)
Research Explorer (The University of Manchester) (submittedVersion)
Funders: National Institute for Health and Care Research
NIH Clinical Center
Topics: Health Sciences › Medicine › Nephrology › Chronic Kidney Disease and Diabetes
Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
Keywords: atorvastatin, type 2 diabetes, diabetic nephropathy, albuminuria, estimated glomerular filtration rate, cardiovascular disease, stroke, statins, albumin-creatinine ratio, cardioprotection, estimated glomerular filtration rate decline
MeSH terms: Atorvastatin, Aged, Albuminuria, Cardiovascular Diseases, Diabetes Mellitus, Type 2, Diabetic Nephropathies, Female, Glomerular Filtration Rate, Heptanoic Acids, Humans, Male, Middle Aged, Pyrroles, Hydroxymethylglutaryl-CoA Reductase Inhibitors

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Effects of Atorvastatin on Kidney Outcomes and Cardiovascular Disease in Patients With Diabetes: An Analysis From the Collaborative Atorvastatin Diabetes Study (CARDS)

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