Original Paper

Statins Do Not Affect Mineral Metabolism in Chronic Kidney Disease: A Retrospective Analysis
Neil Ashman^a, Anindya Banerjee^b, Muhammad M. Yaqoob<sup>a

a</sup>Renal Unit, St Bartholomew's and Royal London Hospitals, London, and
^bRenal Unit, Arrowe Park University Hospital Foundation NHS Trust and Countess of Chester Foundation Hospital NHS Trust, Chester, UK

Address of Corresponding Author

Nephron Clin Pract 2009;111:c236-c239 (DOI: 10.1159/000208992)

  Key Words

• Chronic kidney disease
• Statins
• Mineral metabolism

  Abstract

It has recently been proposed that statins act as vitamin D analogs in binding the ubiquitously expressed vitamin D receptor, accounting for the perceived pleiotropic effects of statins (a reduction in cancer risk, prevention of organ transplant rejection and autoimmune disease). Chronic kidney disease (CKD) offers a useful test of this hypothesis: serum 25-hydroxyvitamin D levels are insufficient (<75 nmol/l) in as many as 76% of patients with advanced CKD, associated with secondary hyperparathyroidism and reduced bone mineralization. Vitamin D suppresses parathyroid hormone (PTH) secretion in part through its action on the vitamin D receptor. If statins act as vitamin D analogs, they may then be able to suppress PTH secretion in CKD. We examined data on 714 vitamin D analog naïve patients with stage 3-4 CKD. 404 patients were treated with a statin indicated almost exclusively for primary prevention of coronary heart disease, and 310 patients were not. Both groups were similar in characteristics. Statins had no effect on the intact PTH concentration, the percentage of patients achieving K/DOQI PTH targets, or on calcium or phosphate concentrations. In patients with stage 3-4 CKD, statins had no effect on secondary hyperparathyroidism. If the hypothesis contending that statins act as vitamin D analogs to exert pleiotropic effects is true, this is of no clinical benefit in the prevention of secondary hyperparathyroidism in CKD.

Copyright © 2009 S. Karger AG, Basel

  Author Contacts

Dr. Neil Ashman
Renal Unit, St Bartholomew's and Royal London Hospitals
London E1 1BB (UK)
Tel. +44 20 7377 7289, Fax +44 20 7377 7003
E-Mail neil.ashman@bartsandthelondon.nhs.uk

  Article Information

N.A. and A.B. contributed equally to this work.

Received: July 28, 2008
Accepted: September 22, 2008
Published online: March 14, 2009
Number of Print Pages : 4
Number of Figures : 2, Number of Tables : 3, Number of References : 13