Comparative Effects of Statins on the Kidney Function in Patients with Type 2 Diabetes.
AIM
Whether there are differences among statins in their effect on the kidney function in diabetic patients remains controversial. In this report, we aimed to examine the comparative effects of statins on the kidney function in a long-term follow-up study.


METHODS
This was a single-center longitudinal observational historical cohort study. We enrolled 326 Japanese adult ambulatory patients with type 2 diabetes who were newly prescribed one of four statins (pravastatin, rosuvastatin, atorvastatin and pitavastatin) and who had an estimated glomerular filtration rate (eGFR) of ≥30 mL/min/1.73m(2). The outcome measurement was the annual rate of change in eGFR. We used the standardized inverse probability of treatment weighted (IPTW) method based on the propensity score to adjust for the effects of confounding factors. Furthermore, in order to take into account the variety in the number and spacing of eGFR measurements and the duration of the follow-up period for each individual, we conducted a linear mixed-effects model regression analysis.


RESULTS
The median follow-up period was 4.3years (range, 3.0-7.1years). In an analysis using the IPTW method, the mean (±standard error) annual rate of change in eGFR among the patients treated with pravastatin (-0.86±0.28 mL/min/1.73m(2)/year) was significantly lower than that observed among the patients treated with rosuvastatin (-1.80±0.27, p=0.02), atorvastatin (-1.99± 0.28, p=0.004) and pitavastatin (-2.23±0.49, p=0.02). Similar results were obtained in the linear mixed-effects model regression analysis.


CONCLUSIONS
Pravastatin may be superior to rosuvastatin, atorvastatin and pitavastatin in preserving the kidney function in patients with type 2 diabetes.