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Do Statins Reduce Dialysis patients' Risk of Heart Disease?
Do Statins Reduce Dialysis patients' Risk of Heart Disease? -- Posted by Gumbo on 12-05-04 06:59
Do Statins Reduce Dialysis patients' Risk of Heart Disease?
International researchers have, for the first time, presented findings from
the landmark 4D trial about whether a cholesterol-reducing drug decreases
the risk of heart attacks and strokes with type 2 diabetics on dialysis at
the American Society of Nephrology's 37th Annual Meeting and Scientific
Exposition in St. Louis.
The 4D trial is the first study to examine the use of statins in type 2
diabetics with kidney failure or end-stage renal disease (ESRD), as well as
to study cardiovascular outcomes in dialysis patients overall. "The findings
will contribute to the understanding of the mechanisms of cardiovascular
disease in type 2 diabetics on hemodialysis treatment and will help to guide
treatment options," said lead author of the study, Christoph Wanner,
professor of medicine and chief of the nephrology division at the University
Clinic, Wuerzburg, Germany.
The recent ASCOT and CARDS trials have demonstrated that atorvastatin
provides significant cardiovascular benefits in patients with type 2
diabetes who do not yet have significant kidney disease and suggest that
these patients be treated early with preventive therapy to lower their
cardiovascular risk. The 4D trial findings will show whether the use of
atorvastatin is also beneficial in type 2 diabetics who have progressed to
kidney failure where hemodialysis is the only option to keep them alive.
The "Deutsche Diabetes Dialyse Studie" (4D study) is a prospective,
randomized, double-blind study involving 1255 patients at 178 dialysis
centers throughout Germany who took either 20 mg of atorvastatin or placebo
between 1998 through February 2004. The study examines the effectiveness and
safety of atorvastatin, an HMG-CoA reductase inhibitor (HMGRI), in patients
with type 2 diabetes on maintenance hemodialysis.
As is typical for patients with end-stage kidney disease (ESRD), a large
proportion of patients in the trial suffered from other diseases, such as
hypertension, congestive heart failure, peripheral artery disease and
cardiac disease. Between 20 and 30% had suffered a prior heart attack or had
undergone revascularization and heart surgery. All patients suffered from
advanced stage diabetes, including retinopathy, degenerative nerve disease,
blindness, and diabetic gangrene.
Cardiovascular disease is the leading cause of death among patients with
kidney failure or ESRD. Cardiovascular damage begins as soon as the kidney
loses function and increases in severity during the progression of kidney
disease. Patients with type 2 diabetes who require dialysis, due to kidney
failure, are about 30 times more likely to die of cardiovascular disease,
including heart attacks and strokes, than the general population. This
article was prepared by Biotech Week editors from staff and other reports.
Copyright 2004, Biotech Week via NewsRx.com & NewsRx.net.
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