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J Nephropathol. 2016;5(3): 98-104.
doi: 10.15171/jnp.2016.18
PMID: 27540537
PMCID: PMC4961823
Scopus ID: 84979010013
  Abstract View: 3773
  PDF Download: 1717

Original Article

The association between atorvastatin administration and plasma total homocysteine levels in renal transplant recipients

Ali Monfared, Seyyede Zeinab Azimi*, Ehsan Kazemnezhad

1 Urology Research Center, Guilan University of Medical Sciences, Guilan, Iran
*Corresponding Author: *Corresponding author: Seyyede Zeinab Azimi, Department of Nephrology, Razi Hospital, Urology Research Center, Guilan University of Medical Sciences, Guilan, Iran, Email: sz.azimi@yahoo.com

Abstract

Background: Statins improve prognosis in patients with coronary heart diseases by decreasing the incidence of vascular events. Excess prevalence of hyperhomocysteinemia, an independent risk factor of cardiovascular diseases, has been observed in stable renal transplant recipients (RTRs). 

Objectives: The objective of our study was to evaluate the association between atorvastatin  administration and plasma total homocysteine (tHcy) levels in RTRs. 

Patients and Methods: We performed a retrospective cross-sectional study in 148 cyclosporine A (CsA) treated stable RTRs. We compared tHcy level and other demographic and clinical variables in RTRs with and without atorvastatin. Results: 58.1% of the 148 RTRs were treated with atorvastatin (20-40 mg/day). Mean tHcy levels were lower in patients treated with atorvastatin compared to nonusers (14.80 ± 5.13 µmol/l versus 16.95 ± 7.87 µmol/l, P = 0.04). The comparison of 85 patients treated with atorvastatin and 61 non-users revealed that those subjects with atorvastatin were older, with higher estimated creatinine clearance and elevated body mass index (BMI). They were more likely to have higher systolic blood pressure and CsA trough level (C0). The association between lower tHcy levels and atorvastatin use was confirmed in the multivariate regression model (P = 0.004). However tHcy levels were independently and negatively associated with serum folate (P = 0.0001) and vitamin B12 levels (P = 0.001) and positively with serum BUN (P = 0.001) and diastolic blood pressure (P = 0.024) as well. 

Conclusions: These data support the association between lower tHcy levels and atorvastatin administration in RTRs. Further clinical trials are recommended to clarify homocysteine lowering effect of atorvastatin.


Implication for health policy/practice/research/medical education:

Cardiovascular disease is one of the most common causes of mortality in dialysis patients. Also, hyperhomocysteinemia isconsidered as a risk factor for atherosclerosis that in dialysis patients is more prevalent comparing with other patients. Hence,risk of atherosclerosis and cardiovascular death would be reduced in case of hyperhomocysteine amendment.

Please cite this paper as: Monfared A, Azimi SZ, Kazemnezhad E. The association between atorvastatin administration andplasma total homocysteine levels in renal transplant recipients. J Nephropathol. 2016;5(3):98-104. DOI: 10.15171/jnp.2016.18

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ePublished: 07 Apr 2016
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