Effect of Pitavastatin on Erythrocyte Membrane Fatty Acid Contents in Patients With Chronic Kidney Disease
Status:
Completed
Trial end date:
2020-12-31
Target enrollment:
Participant gender:
Summary
Patients with chronic kidney disease (CKD) are high risk for death and cardiac disease is the
major cause of death. CKD patients commonly have traditional risk factors for coronary artery
disease, such as age, gender, hypertension, cigarette smoking, and dyslipidemia. Previous
studies have reported that reducing cholesterol levels is associated with reducing morbidity
and mortality from atherosclerosis. In particular, pharmacologic treatment using statin has
been decreased the risk of adverse cardiovascular events in CKD population. Therefore,
guidelines recommended the use of statin in CKD patients. On the other hands, niacin or
fibrates is not recommended concomitantly with statins in patients with CKD because of
increased risk of adverse events. In addition, recent study has reported that there was no
incremental clinical benefit from the addition of niacin to statin therapy, in further
decreasing the incidence of major cardiac events.
Supplementation with omega-3 fatty acid (FA) lowers the risk of cardiovascular death in
patients with myocardial infarction. This cardioprotective effect of omega-3 FA can be
explained by anti-inflammatory, anti-oxidative, or anti-thrombic effects. In addition,
omega-3 FA modulates cell membrane receptors and affects signal transduction and eicosanoid
metabolism. The erythrocyte membrane content of FA has been shown to correlated with the FA
content of the myocardium. The risk of cardiovascular disease is significantly reduced in
patients with high omega-3 FA, such as eicosapentanoic acid or docosahexaenoic acid (DHA), in
the erythrocyte membrane. In contrast, high levels of erythrocyte membrane total trans-FA,
trans-oleic acid, and arachidonic acid (AA) are associated with an increased risk of
cardiovascular disease. Erythrocyte membrane monounsaturated FA (MUFA) content, including
oleic acid, is significantly higher in patients with acute coronary syndrome than control
subjects. The erythrocyte membrane oleic acid content was also higher in dialysis patients
who have high risks of cardiovascular disease compared to control subjects. Therefore, the
modification of erythrocyte membrane FA content is very important with respect to
cardiovascular disease. In a previous study, erythrocyte membrane omega-3 FA was shown to be
increased and the MUFA content was decreased after omega-3 FA supplementation in HD patients.
However, there are no reports about the effect of statin on the erythrocyte membrane FA
composition in CKD. Recent study has reported that those with pitavastatin 4mg were decreased
DHA to AA ratio, but those with pravastatin 20 mg were not change the DHA to AA ratio in
patient with CAD. Statin may have important role on the modulation of erythrocyte membrane
FA. In this study, the investigators hypothesized that pitavastatin supplementation can
modify erythrocyte membrane FA content, including MUFA and oleic acid, in CKD patients. In
addition, the investigators evaluated the effect of pitavastatin on adiponectin and glucose
level in CKD patients.