PRAVASTATIN TREATMENT IN PATIENTS WITH HYPERCHOLESTEROLEMIA AND NEPHROPATHY

The effectiveness and safety of pravastatin (20 mg at bed time), and its effects on proteinuria and progression of renal failure were evaluated in 55 patients with nephropathy. Five patients were excluded in the first month (7 due to rhabdomiolysis, 1 due to gastrointestinal discomfort and 3 due to poor complianre with treatment). Fifty patients carried on the study: Thirteen patients showed nephrotic proteinuria, 35 significant proteinuria, 42 renal insufficiency and 29 proteinuria and renal insufficiency. Forty-five patients completed I year treatment (two patients started dialysis, 1 suffered from gastrointestinal discomfort and 2 were excluded because of poor compliance with treatment). Total serum cholesterol fell by 23 % and LDL-cholesterol by 29 %. There were no significant changes in tryglicerides and HDL-cholesterol concentrations. A 25 % fall was observed in apolipoprotein B. There were no significant changes in proteinuria. To evaluate changes in progression of renal failure the slopes of reciprocal of serum creatinine versus time were calculated before and during I year treatment for each patient. Slopes were not significantly different. We conclude that pravastatin is a safe and effective cholesterol-lowering therapy in nephrologic patients. Long-term studies are necessary to evaluate its effects on progression renal failure.