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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)
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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“As statin trials have not consistently shown renoprotective effects, despite moderate triacylglycerol reduction [28][29][30]”
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Metadata
- 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.
- Venue
- American Journal of Kidney Diseases
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 54
- Issue
- 5
- Pages
- 810-819
- ISSN
- 0272-6386 (ISSN-L)
- 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
- 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 › Cardiology and Cardiovascular Medicine › 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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