Do statins make you urinate more
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Do Statins Make You Urinate More?
Statins and Urinary Albumin Excretion
Statins, commonly prescribed to manage cholesterol levels and prevent cardiovascular events, have been studied for their effects on renal outcomes, including urinary albumin excretion (UAE). Research indicates that statins can influence UAE, but the results are mixed. In a randomized controlled trial (RCT) and an observational cohort study, pravastatin did not significantly change UAE levels. However, in the observational cohort, statin use was associated with a notable increase in UAE, particularly among long-term users and those on higher doses1. This suggests that while statins may not universally affect UAE, certain conditions and durations of use might lead to increased urinary albumin excretion.
Statins and Kidney Function
The impact of statins on kidney function, particularly glomerular filtration rate (GFR), has been a subject of extensive research. A meta-analysis of multiple studies found that statins modestly reduce the rate of kidney function decline, especially in individuals with cardiovascular disease2. Another meta-analysis focusing on chronic kidney disease (CKD) patients revealed that high-intensity statins significantly improved GFR, whereas moderate- and low-intensity statins did not show a significant effect3. These findings highlight that the intensity of statin therapy plays a crucial role in its renal benefits.
Statins and Urinary Protein Excretion
Statins have also been evaluated for their effects on urinary protein excretion. A systematic review and meta-analysis concluded that statins modestly reduce proteinuria, which is a marker of kidney damage2. However, another meta-analysis found no significant reduction in proteinuria among CKD patients treated with statins3. This discrepancy suggests that the effect of statins on proteinuria may vary depending on the patient population and the specific conditions of the study.
Statins and AQP2 Urinary Excretion
A study investigating the effects of simvastatin on AQP2 urinary excretion in hypercholesterolemic patients found that statin therapy significantly increased AQP2 levels in urine, reduced 24-hour diuresis, and increased urine osmolality4. These results indicate that statins may enhance the kidney's ability to concentrate urine, which could potentially reduce the frequency of urination.
Conclusion
In summary, while statins do not universally increase urinary frequency, they can influence various aspects of renal function and urinary excretion. Statins may increase urinary albumin excretion in certain conditions and improve kidney function, particularly with high-intensity therapy. Additionally, statins can enhance urine concentration by increasing AQP2 excretion, potentially reducing the need for frequent urination. However, the effects on proteinuria are less consistent and may depend on the specific patient population and study conditions.
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Most relevant research papers on this topic
The effect of statins on urinary albumin excretion and glomerular filtration rate: results from both a randomized clinical trial and an observational cohort study.
Statins do not lower urinary albumin excretion in patients with hyperlipidaemia, and may increase it in those with modestly impaired glomerular filtration rate.
RCT
Large Human Trial
Highly CitedStatins for improving renal outcomes: a meta-analysis.
Statin therapy may modestly reduce proteinuria and slow kidney function loss, especially in individuals with cardiovascular disease.
Meta-AnalysisHighly CitedEffects of Statins on Renal Outcome in Chronic Kidney Disease Patients: A Systematic Review and Meta-Analysis
High-intensity statins improve decline in eGFR in chronic kidney disease patients not requiring dialysis, but moderate- and low-intensity statins do not, and they do not decrease proteinuria.
Meta-Analysis
Rigorous JournalHighly CitedSimvastatin increases AQP2 urinary excretion in hypercholesterolemic patients: A pleiotropic effect of interest for patients with impaired AQP2 trafficking
Simvastatin effectively increases AQP2 urinary excretion in hypercholesterolemic patients, potentially enhancing current pharmacological treatment for patients with urine-concentrating defects caused by defective AQP2 trafficking.
Non-RCTRigorous JournalThe effect of statins on microalbuminuria, proteinuria, progression of kidney function, and all-cause mortality in patients with non-end stage chronic kidney disease: A meta-analysis.
Statins statistically reduced microalbuminuria, proteinuria, and clinical deaths in non-end stage chronic kidney disease patients, but did not effectively slow clinical progression.
Meta-AnalysisRigorous JournalThe Effect of Statin Therapy on Serum Uric Acid Levels: A Systematic Review and Meta-Analysis.
Statin therapy significantly reduces serum uric acid levels, particularly with atorvastatin, making it the most appropriate cholesterol-lowering agent for patients with or at risk of hyperuricemia.
Meta-AnalysisThe Effect of Statins on the Incidence and Prognosis of Bladder Cancer: A Systematic Review and Meta-Analysis
Statins have a neutral effect on bladder cancer local control, recurrence, survival, and mortality, and have no significant effect on bladder cancer risk compared to non-users.
Meta-AnalysisMeta-analysis of the effect of statins on renal function.
Statins may slow the progression of pathologic proteinuria and decrease the rate of decline in estimated glomerular filtration rate.
Meta-AnalysisMeta-Analysis: The Effect of Statins on Albuminuria
Statins may reduce albuminuria, a marker of endothelial dysfunction and a risk factor for cardiovascular disease, but larger, better-confirmed studies are needed to confirm these findings and determine their impact on end-stage renal disease or cardiovascular disease.
Meta-AnalysisHighly CitedStatins ameliorate cholesterol-induced inflammation and improve AQP2 expression by inhibiting NLRP3 activation in the kidney
Statins can improve kidney function and reduce inflammation in high-fat diet animals by promoting ASC speck degradation and enhancing aquaporin expression.
Non-RCT
Animal StudyRigorous Journal