Internal Medicine
Online ISSN : 1349-7235
Print ISSN : 0918-2918
ISSN-L : 0918-2918
Renal and Vascular Protective Effects of Ezetimibe in Chronic Kidney Disease
Tatsuyori MoritaSatoshi MorimotoChikara NakanoRika KuboYoshiki OkunoMaiko SeoKazunori SomeyaMitsutaka NakahigashiHiroko UedaNagaoki ToyodaMakiko KusabeFusakazu JoNobuyuki TakahashiToshiji IwasakaIchiro Shiojima
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2014 Volume 53 Issue 4 Pages 307-314


Objective Dyslipidemia is a risk factor for not only cardiovascular diseases (CVD), but also chronic kidney disease (CKD). Ezetimibe, a cholesterol absorption inhibitor, lowers cholesterol levels by inhibiting both extrinsic and intrinsic cholesterol absorption via the gastrointestinal duct. However, very few studies have examined its efficacy and safety for patients with dyslipidemia complicated with CKD.
Methods Thirty-seven dyslipidemic patients (low density lipoprotein cholesterol (LDL-C) levels ≥120 mg/dL) complicated with CKD were given ezetimibe (10 mg/day) for twenty-four weeks. The efficacy and safety of the therapy, including the anti-atherosclerotic and renal protective effects, were then examined.
Results Significant decreases were observed in the levels of LDL-C (158.9±26.9 mg/dL→123.0±31.8 mg/dL; p<0.0001), remnant-like lipoprotein cholesterol (9.3±5.3 mg/dL→7.3±3.8 mg/dL; p<0.05) and lipoprotein (a) (22.0±16.1 mg/dL→16.4±11.0 mg/dL; p<0.01). The estimated glomerular filtration rate did not change, but the urine protein to creatinine ratio decreased significantly (1,107.3±1,454.2 mg/gCre→732.1±1,237.8 mg/gCre; p<0.05). No changes were observed in the carotid intima media thickness, but the brachial-ankle pulse wave velocity decreased significantly (1,770.4±590.3 cm/sec→1,702.5±519.9 cm/sec; p<0.05). No adverse events were observed.
Conclusion Ezetimibe can be safely administered even to patients with CKD. The results of this study indicate that ezetimibe may provide some renal protection and suppress the complications of CVD in CKD patients.

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© 2014 by The Japanese Society of Internal Medicine
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