A quarter of all heart attacks, strokes and operations to open blocked arteries could be avoided in patients with chronic kidney diseases – if the patients take a long term treatment of the blood lipid lowering drugs ezetimibe and simvastatin.
"In this way, about 250,000 people worldwide could be spared from this cardiovascular disease," says principal investigator Professor Colin Baigent of the University of Oxford.
This is the conclusion of the so-called Sharp study, the results of which were presented for the first time at the Nephrology Convention held in the United States on 20 November. This is the largest study of kidney patients ever conducted: It included altogether 9,480 patients from more than 380 hospitals in 18 countries over a time span of ten years. About one third of the patients had already progressed to the stage of dialysis.
Würzburg recruited 1,800 patients
The Department of Medicine I of the University of Würzburg served as a coordinating center for Germany and Austria. Professor Christoph Wanner was the regional coordinator for Central Europe; Associate Professor Vera Krane acted as a study coordinator. "We started the planning in collaboration with Oxford in spring 2001," says Professor Wanner. He and his team recruited altogether 1,800 patients for the study.
The risk of heart attacks and strokes is very high in patients with chronic kidney disease. "Previously, in the prevailing scientific opinion, the higher risk was not thought to be connected to the blood lipid levels so that a reduction of the blood lipid levels would seem to be of no benefit to the patients," says Professor Wanner. This opinion can now be rejected. The fact that blood lipid lowering drugs reduce the risk of cardiovascular diseases in healthy people has long been known.
Side effects of the treatment
"There was no evidence in the study of any adverse side effects of the treatment," says co-principal investigator Martin Landray from Oxford. Earlier concerns that ezetimibe might cause cancer were not confirmed either: "The study clearly shows that the treatment is safe."
Information on chronic kidney disease
Chronic kidney disease is a slowly progressing loss in kidney function over a period of several years. The people most at risk are diabetics, smokers, overweight people and patients with high blood pressure. At the end stage, the kidney function drops to only 15 percent or less. When this stage is reached, renal treatment in form of dialysis or a transplant is required. According to the SHARP study, a reduction of the blood lipid levels is beneficial in any case – no matter how far the disease has already progressed.
Prof. Dr. Christoph Wanner, Department of Medicine I, Nephrology Department, University of Würzburg, T +49 (0)931 201-36330, email@example.com
Robert Emmerich | idw
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