Effects of atorvastatin on NGAL and cystatin C in chronic kidney disease: a post hoc analysis of the LORD trial

Fassett, Robert G., Robertson, Iain K., Ball, Madeleine J., Geraghty, Dominic P., Cardinal, John W. and Coombes, Jeff S. (2012) Effects of atorvastatin on NGAL and cystatin C in chronic kidney disease: a post hoc analysis of the LORD trial. Nephrology, Dialysis, Transplantation, 27 1: 182-189. doi:10.1093/ndt/gfr193


Author Fassett, Robert G.
Robertson, Iain K.
Ball, Madeleine J.
Geraghty, Dominic P.
Cardinal, John W.
Coombes, Jeff S.
Title Effects of atorvastatin on NGAL and cystatin C in chronic kidney disease: a post hoc analysis of the LORD trial
Formatted title
Effects of atorvastatin on NGAL and cystatin C in chronic kidney disease: A post hoc analysis of the LORD trial
Journal name Nephrology, Dialysis, Transplantation   Check publisher's open access policy
ISSN 1460-2385
1460-2385
Publication date 2012-01
Year available 2011
Sub-type Critical review of research, literature review, critical commentary
DOI 10.1093/ndt/gfr193
Volume 27
Issue 1
Start page 182
End page 189
Total pages 8
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Collection year 2012
Language eng
Formatted abstract
Background.
Neutrophil gelatinase-associated lipocalin (NGAL) and cystatin C are biomarkers of kidney injury and function, respectively. This study assessed whether plasma NGAL and/or serum cystatin C predicted baseline estimated glomerular filtration rate (eGFR) and urinary protein excretion, rate of change of eGFR and urinary protein excretion and whether atorvastatin influenced changes in these biomarkers in patients with chronic kidney disease (CKD).

Methods.
This is a post hoc analysis of the Lipid Lowering and Onset of Renal Disease trial, a randomized double-blind, placebo-controlled trial where 88 patients with Stages 2-4 CKD received atorvastatin 10 mg/day (48) or placebo (40). Stored blood samples were analysed for NGAL and cystatin C at baseline and a mean of 1.5 and 2.9 years later. Serum creatinine and Modification of Diet in Renal Disease (MDRD) eGFR were obtained three monthly.

Results.
There were negative associations between NGAL and cystatin C and eGFR (P = 0.025 and P < 0.001, respectively) at all time points. There were no associations between baseline NGAL and cystatin C and rate of change of eGFR (P = 0.44 and P = 0.49, respectively). Baseline NGAL but not cystatin C (P = 0.043 and P = 0.35, respectively) predicted rate of change of urinary protein excretion. In atorvastatin-treated patients, NGAL decreased (mean,-7.4 ng/mL/year; SD 128.4), whereas it increased in the placebo group [mean, 4.6 ng/mL/year; SD 56.6), the difference being statistically significant (P = 0.049).

Conclusions.
NGAL is a biomarker of existing CKD but did not predict CKD progression. Atorvastatin reduced plasma NGAL but the significance and mechanisms require further investigation. Atorvastatin had no significant effect on cystatin C.
Keyword Biomarkers
Chronic kidney disease
Glomerular filtration rate
Proteinuria
Statins
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Published online: 4 May 2011.

Document type: Journal Article
Sub-type: Critical review of research, literature review, critical commentary
Collections: Official 2012 Collection
School of Human Movement and Nutrition Sciences Publications
School of Medicine Publications
 
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Created: Fri, 30 Sep 2011, 14:21:32 EST by Matthew Lamb on behalf of School of Medicine