Effects of atorvastatin on oxidative stress in chronic kidney disease

Aim Statins have pleiotropic effects that include attenuation of oxidative stress that may be relevant for chronic kidney disease ( CKD ) patients. We investigated the effect of long‐term atorvastatin therapy on oxidative stress biomarkers in CKD patients. Methods This was a pre‐specified secondary analysis of data from a randomized, double‐blind, placebo‐controlled trial ( L ipid lowering and O nset of R enal D isease, LORD ) in CKD patients. Participants received 10 mg/day atorvastatin ( n  = 47) or placebo ( n  = 39) for 3 years. Plasma measures (total F2‐isoprostanes, malondialdehyde. protein carbonyls, uric acid, glutathione peroxidase ( GPx ) activity and total antioxidant capacity ( TAC ) ) were performed at baseline and at 3 years. Age and sex matched participants ( n  = 34) with normal kidney function were controls. Results CKD patients had significantly ( P  < 0.05) increased F 2‐isoprostanes and uric acid and decreased GPx activity compared with controls. When comparing the treatment (atorvastatin (A) vs placebo ( P ) ) change from baseline to 3 years, there were no significant differences ( P  > 0.05) in the group difference of the change values: (mean (95% CI ), F2‐isoprostanes = 5.3 (−29.2 to 39.8) pg/mL, protein carbonyls = 0.03 (−0.13 to 0.19) nmol/mg, GPx activity = −0.10 (−4.73 to 4.52) ( U /L), uric acid = 8.8 (−33.9 to 51.6) μmol/L or TAC  = −0.03 (−0.10 to 0.04) mmol/L. A significant difference ( P  = 0.04) in the change in malondialdehyde between groups, 1.52(0.09 to 2.96) μmol/L, was due to a large decrease in the placebo group. Conclusion CKD patients had elevated oxidative stress that was not attenuated by atorvastatin 10 mg/day for 3 years.