Effects of atorvastatin on biomarkers of inflammation in chronic kidney disease

Background: CKD is associated with increased levels of inflammatory biomarkers.. The effects of atorvastatin on biomarkers of inflammation were assessed in CKD patients.

Methods: One hundred and seventeen patients with serum creatinine > 120 μmol/l were randomized to receive atorvastatin 10 mg/day (56) or placebo (61) and followed for a mean of 2.5 years. Thirty-three individuals with normal kidney function were controls. Outcomes included comparison of changes in pentraxin-3 (PTX3), TNF-α, CRP, IL-6, IL-8 and IL-10 between atorvastatin and placebo-treated patients.

Results: At baseline, compared with controls, CKD patients had increased PTX3 (mean, 1.08 vs 0.58 ng/ml; P < 0.001), CRP (mean, 4.9 vs 1.5 mg/l; P < 0.001), Il-8 (mean, 6.00 vs 4.58 pg/ml; p = 0.001), Il-10 (mean, 59.0 vs 17.6 pg/ml; p = 0.007) and TNF-α (mean, 18.0 vs 5.6 ng/ml; p < 0.001). In patients with raised baseline plasma IL-6/8/10 and/or PTX3 the eGFR decline was significantly less in those treated with atorvastatin compared to placebo (mean change, -3.36; vs +1.25 ml/min/1.73m²/yr; difference, 4.61 95% CI 0.98-8.25; p = 0.002), whilst those without raised inflammatory biomarkers showed no difference. Placebo-treated patients with raised TNF-α levels had no eGFR decline (p = 0.16).

Conclusions: CKD patients had increased biomarkers of inflammation. Those with raised IL-6/8/10 and/or PTX3 at baseline had significantly less eGFR decline when treated with atorvastatin. Atorvastatin may slow eGFR decline in CKD patients with inflammation.