KRONIČNA BOLEST BUBREGA I STATINI

MIRJANA SABLJAR MATOVINOVIĆ

Dislipidemija i kronična bolest bubrega često se javljaju udružene i neovisni su čimbenici kardiovaskularnog rizika. Osim toga, dislipidemija pridonosi ne samo nastanku već i napredovanju kronične bubrežne bolesti u općoj popula­ciji, u bolesnika sa šećernom bolesti i onih s različitim bolestima bubrega. Budući da statini smanjuju kardiovaskularni rizik, postavlja se pitanje njihove djelotvornosti u kroničnoj bolesti bubrega. Rezultati dosada provedenih istraživanja s velikim brojem uključenih ispitanika pokazali su da statini sprečavaju nastanak i odgađaju napredovanje oštećenja već postojeće bolesti bubrega, osobito u bolesnika s umjereno oštećenom ftmkcijom bubrega. Statini smanjuju rizik od nastanka kardiova­skularnih komplikacija u bolesnika s umjerenim i manje u onih s blagim oštećenjem funkcije bubrega, kao i u transplantiranih bolesnika, ali ne smanjuju u bolesnika na hemodijalizi, odnosno u 4. i 5. stadiju oštećenja funkcije bubrega. U tijeku su istraživanja na velikom broju bolesnika koja će vjerojatno dati konačne odgovore na pitanja o djelotvornosti statina u kroničnoj bolesti bubrega.

Summary. Dyslipidemia is a risk factor for de novo occurrence of renal disease in apparently healthy population, and diabe- tes, and contributes to progressive decline of renal function in diabetic and nondiabetic kidney disease. Chronic kidney disease and dyslipidemia, frequently occurring together, are independent cardiovascular risk factors. There is a strong asso- ciation between the level of renal insufficiency and cardiovascular disease. According to available evidence, statin therapy may reduce cardiovascular risk in chronic kidney disease as well as modify its course, especially in patients with moderate impairment of renal function. However, all these findings must be examined in large-scale trials in patients with chronic renal disease and different stages of renal insufficiency. There are several on-going trials aimed at determing the role of statin therapy in this specific population, and confirming its efficacy in reducing cardiovascular risk and halting the progres- sion of chronic kidney disease.