亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整的填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Effect of Pravastatin in People with Diabetes and Chronic Kidney Disease

普伐他汀 肾脏疾病 医学 糖尿病 内科学 2型糖尿病 内分泌学 重症监护医学 胆固醇
作者
Marcello Tonelli,Anthony Keech,Jim Shepherd,Frank M. Sacks,Andrew Tonkin,Chris J. Packard,Marc A. Pfeffer,John Simes,Chris Isles,Curt D. Furberg,Malcolm West,Tim Craven,Gary C. Curhan
出处
期刊:Journal of The American Society of Nephrology 卷期号:16 (12): 3748-3754 被引量:164
标识
DOI:10.1681/asn.2005070779
摘要

Although diabetes is a major cause of chronic kidney disease (CKD), limited data describe the cardiovascular benefit of hydroxymethyl glutaryl CoA reductase inhibitors (statins) in people with both of these conditions. This study sought to determine whether pravastatin reduced the incidence of first or recurrent cardiovascular events in people with non–dialysis-dependent CKD and concomitant diabetes, using data from three randomized trials of pravastatin 40 mg daily versus placebo. CKD was defined by estimated GFR <60 or 60 to 89.9 ml/min per 1.73 m2 with proteinuria. Of 19,737 patients, 4099 (20.8%) had CKD but not diabetes at baseline, 873 (4.4%) had diabetes but not CKD, and 571 (2.9%) had both conditions. The primary composite outcome was time to myocardial infarction, coronary death, or percutaneous/surgical coronary revascularization. Median follow-up was 64 mo. After adjustment for trial and random treatment assignment, the incidence of the primary outcome was lowest in individuals with neither CKD nor diabetes (15.2%), intermediate in individuals with only CKD (18.6%) or only diabetes (21.3%), and highest in individuals with both characteristics (27.0%). Pravastatin reduced the relative likelihood of the primary outcome to a similar extent in subgroups defined by the presence or absence of CKD and diabetes. For example, pravastatin was associated with a significant reduction in the relative risk of the primary outcome by 25% in patients with CKD and concomitant diabetes and by 24% in individuals with neither characteristic. However, the absolute reduction in the risk of the primary outcome as a result of pravastatin use was highest in patients with both CKD and diabetes (6.4%) and lowest in individuals with neither characteristic (3.5%). In conclusion, stage 2 or early stage 3 CKD and diabetes both are associated with higher cardiovascular risk, and pravastatin reduces cardiovascular event rates in people with neither, one, or both characteristics. Given the high absolute benefit of pravastatin in patient with diabetes and stage 2 or early stage 3 CKD, this population in particular should be targeted for widespread use of statins. Additional studies are needed to determine whether these benefits apply to patients with more severe CKD, and recruitment to such studies should be given high priority.

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
大幅提高文件上传限制,最高150M (2024-4-1)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
悦耳的三毒完成签到 ,获得积分10
6秒前
46秒前
天气真好发布了新的文献求助10
46秒前
1分钟前
邹老头发布了新的文献求助10
1分钟前
1分钟前
1分钟前
1分钟前
Chondrite发布了新的文献求助10
1分钟前
1分钟前
yutang发布了新的文献求助10
1分钟前
1分钟前
1分钟前
1分钟前
Chondrite完成签到,获得积分10
1分钟前
开放思烟发布了新的文献求助10
1分钟前
慕青应助开放思烟采纳,获得10
1分钟前
香蕉觅云应助天气真好采纳,获得10
1分钟前
AME完成签到 ,获得积分10
1分钟前
缪慧敏完成签到,获得积分20
2分钟前
2分钟前
wanci应助缪慧敏采纳,获得30
2分钟前
天气真好发布了新的文献求助10
2分钟前
Jasper应助南风采纳,获得10
2分钟前
3分钟前
激动的似狮完成签到,获得积分10
3分钟前
3分钟前
南风发布了新的文献求助10
3分钟前
南风完成签到 ,获得积分10
3分钟前
樱桃猴子应助筱可可采纳,获得10
3分钟前
3分钟前
充电宝应助天气真好采纳,获得10
3分钟前
4分钟前
天气真好发布了新的文献求助10
4分钟前
Lucas应助忽而今夏采纳,获得30
4分钟前
5分钟前
DRAZ完成签到,获得积分10
5分钟前
Dannnn完成签到 ,获得积分10
5分钟前
5分钟前
狄绮完成签到 ,获得积分10
5分钟前
高分求助中
Licensing Deals in Pharmaceuticals 2019-2024 3000
Effect of reactor temperature on FCC yield 2000
Very-high-order BVD Schemes Using β-variable THINC Method 1020
PraxisRatgeber: Mantiden: Faszinierende Lauerjäger 800
Impiego dell'associazione acetazolamide/pentossifillina nel trattamento dell'ipoacusia improvvisa idiopatica in pazienti affetti da glaucoma cronico 730
錢鍾書楊絳親友書札 600
A new species of Coccus (Homoptera: Coccoidea) from Malawi 500
热门求助领域 (近24小时)
化学 医学 生物 材料科学 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 基因 遗传学 催化作用 物理化学 免疫学 量子力学 细胞生物学
热门帖子
关注 科研通微信公众号,转发送积分 3294504
求助须知:如何正确求助?哪些是违规求助? 2930456
关于积分的说明 8446066
捐赠科研通 2602612
什么是DOI,文献DOI怎么找? 1420680
科研通“疑难数据库(出版商)”最低求助积分说明 660658
邀请新用户注册赠送积分活动 643433