Effects of statins on renal sodium and water handling: acute and short-term effects of atorvastatin on renal haemodynamics, tubular function, vasoactive hormones, blood pressure and pulse rate in healthy, normocholesterolemic humans.

doi:10.1093/NDT/GFM807

Paper

Effects of statins on renal sodium and water handling: acute and short-term effects of atorvastatin on renal haemodynamics, tubular function, vasoactive hormones, blood pressure and pulse rate in healthy, normocholesterolemic humans.

Published May 1, 2008 · L. Paulsen, Charlotte Holm, J. Bech

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association

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Abstract

BACKGROUND Statins have a beneficial effect on cardiovascular morbidity and mortality due to a reduction in plasma cholesterol. However, statins seem to have effects beyond the lowering of plasma cholesterol. We hypothesize that these effects are caused by an effect on renal function. METHODS We measured the effects of atorvastatin (AS) on renal function in two randomized, placebo-controlled, double-blinded and crossover studies in healthy man. In an acute trial (Study 1), 19 subjects received either 80 mg AS as a single dose or placebo. In a short-term trial (Study 2), 20 subjects received either 80 mg AS or placebo daily for 4 weeks. In both studies glomerular filtration rate (GFR), renal plasma flow (RPF), plasma concentrations of angiotensin II (Ang II), renin (PRC), atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), aldosterone (Aldo), vasopressin (AVP) and blood pressure (BP) were determined. RESULTS In Study 1 AS decreased fractional excretion of sodium (FE(Na)) significantly (P = 0.035), but very modestly, and reduced diastolic BP (P = 0.024). Apart from this, we found no significant differences in GFR, RPF, tubular function and vasoactive hormones in either Study 1 or 2. CONCLUSIONS An acute dose of AS decreased FE(Na) and DBP in healthy humans. The reduction in fractional urinary sodium excretion was very modest and transitory, and most likely secondary to the fall in diastolic blood pressure (DBP). However, renal haemodynamics, tubular function, vasoactive hormones and blood pressure were unchanged during short-term statin treatment in healthy man.

RCT

Study Snapshot

Acute dose of atorvastatin reduced fractional excretion of sodium and diastolic blood pressure in healthy humans, but short-term statin treatment did not significantly affect renal function, tubular function, or blood pressure.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Paper

Effects of statins on renal sodium and water handling: acute and short-term effects of atorvastatin on renal haemodynamics, tubular function, vasoactive hormones, blood pressure and pulse rate in healthy, normocholesterolemic humans.

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References

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Short-term statin treatment improves endothelial function and neurohormonal imbalance in normocholesterolaemic patients with non-ischaemic heart failure

Short-term statin treatment improves endothelial function and lowers neurohormonal imbalances in patients with non-ischaemic chronic heart failure and average cholesterol levels.

Citations

Fluorescent Probe for in Vivo Partitioning into Dynamic Lipid Droplets Enables Monitoring of Water Permeability-Induced Edema.

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Statins and ezetimibe use is inversely correlated with severe hyponatremia, making them unlikely culprits in hyponatremia patients and safe to initiate in hyponatremic patients.

Development of a hyponatremia screening tool (ABCDF‐S score) for patients with hypertension using thiazide diuretic agents

The ABCDF-S score is a simple, rapid screening tool for hyponatremia in patients using thiazide diuretics, aiding in rapid and appropriate management.

Comparative evaluation of renal, pleiotropic and myotropic effects of statins in rats

Statins with different lipophilicity (atorvastatin, lovastatin, simvastatin) have slightly increased urine output, moderate growth of glomerular filtration rate, and decreased sodium and protein excretion, maintaining intrarenal autoregulation.

Role of the sodium‐hydrogen exchanger in mediating the renal effects of drugs commonly used in the treatment of type 2 diabetes

Many common diabetes drugs act on the sodium-hydrogen exchanger, potentially explaining their effects on sodium excretion, albuminuria, and glomerular function in patients.