Efficacy of Statin and Non-Statin Therapies for Lipid Abnormalities in CKD: Evidence from Ayub Teaching Hospital

Abstract

Objective: To compare the effectiveness and safety of statin therapy with non-statin management in improving lipid profile and renal outcomes among patients with chronic kidney disease (CKD).

Methodology: The study is a prospective cohort study that will be carried out at the Department of Nephrology, Ayub Teaching Hospital (ATH), Abbottabad, Pakistan, during the period of January to December 2024. Statin therapy (n = 75) and non-statin management (n = 75) comprised the two groups of 150 CKD patients in this comparative analysis. Age, gender, body mass index (BMI), comorbidities, stage of chronic kidney disease (CKD), estimated glomerular filtration rate (eGFR), and lipid profile were among the baseline clinical and demographic features that were documented. Patients were followed for six months. The primary outcomes were achievement of LDL-C <70 mg/dL or ≥50% reduction in LDL-C and mean reduction in LDL-C levels. Secondary outcomes included changes in non-HDL cholesterol, triglycerides, HDL-C, and renal function (eGFR). Safety outcomes such as adverse events, myalgia, elevation of liver enzymes, and major adverse cardiovascular events were also assessed. Statistical analysis was performed using appropriate comparative tests, and a p-value ≤0.05 was considered statistically significant.

Results: Baseline characteristics were comparable between the two groups (p>0.05). At six months, a significantly higher proportion of patients in the statin group achieved LDL-C <70 mg/dL or ≥50% reduction compared with the non-statin group (77.3% vs. 56.0%, p=0.003). The mean reduction in LDL-C was also greater in the statin group (−38.2±21.4 mg/dL) than in the non-statin group (−26.1±23.8 mg/dL; p<0.001). A ≥50% reduction in LDL-C was observed in 48.0% of statin-treated patients compared with 29.3% in the non-statin group (p=0.012). Significant improvements were also observed in non-HDL cholesterol and triglyceride levels in the statin group (p<0.05). The decline in eGFR was smaller among statin users (p=0.045). Safety outcomes were similar in both groups.

Conclusion: Statin therapy significantly improved lipid parameters without increasing adverse events, supporting its role in cardiovascular risk management among CKD patients.