他汀类药物是慢性肾脏病患者的朋友还是敌人?

Statins:friend or foe for chronic kidney disease?

他汀类药物是冠心病治疗的基石。当前研究表明所有阶段的慢性肾脏病(CKD)均容易合并心血管疾病,同样心血管疾病也易合并CKD。数项大规模临床研究亦表明他汀类药物可以减少CKD患者的全因病死率和心血管事件的发生。然而CKD尤其是接受肾脏替代治疗的患者使用他汀类药物治疗在安全性和有效性方面存在争议,同样他汀类药物在减少蛋白尿、延缓肾脏病进展、预防CKD心血管事件有效性等方面也存在争议。

Statins are the keystone for treating coronary disease. The patients at all stages of chronic kidney disease（CKD） have a significantly elevated risk of cardiovascular disease（CVD） compared with the general population, and CVD patients also suffer from CKD easily. Some large clinical trials have revealed that statins might reduce all-cause mortality and cardiovascular events in patients with CKD. However, the results concerning the efficacy and safety of statins therapy in patients with CKD, especially in those on renal replacement therapy, are still controversial. This paper tries to discuss the controversies of statins for CKD in reducing the proteinuria and slowing the decline of glomerular filtration rate, and the efficacy for cardiovascular events and so on.