An update on renoprotective and nephrotoxicity of statins

Abstract

Statins are employed in the treatment of hyperlipidemia. Their main mechanism of action is inhibition of HMG-reductase, however, they have various other effects independent of their cholesterol lowering mechanism. These include anti-inflammatory and anti-oxidant properties. Statins can reduce acute phase reactant. They inhibit vascular micro-inflammation, enhancing endothelial cell function, inhibiting proliferation of vascular smooth muscle, reducing platelet activation and aggregation and increasing atherosclerotic plaque stability. Many of these effects are postulated to arise from disruption of small G-proteins. This is not clear whether statins are nephrotoxic or nephroprotective agents. There is not enough data about their effects on nephrons. Cardiologists and internists use statins widely in many conditions but there is evidences against their safety. Further studies are necessary to determine the biological mechanism of kidney injury in statin users.

Keywords: HMG-CoA reductase inhibitors, Statins, Acute kidney injury, Nephrotoxicity, Renoprotection