Abstract
Simvastatin (Lipovas®), a 3-hydroxy-3-methyl glutaryl coenzyme A (HMG-CoA) reductase inhibitor, was administered at a dosage of 5mg/day for 24 weeks to 38 hemodialysis (HD) patients with a high serum total cholesterol (TC) level (≥200mg/dl) or a low high density lipoprotein cholesterol (HDL-C) level (≤35mg/dl). Every 4 weeks, serum lipids, apolipoprotein, lipoprotein (a) (Lp (a)) and malondialdehyde (MDA) levels were measured, in addition to determination of lipid levels in each lipoprotein fraction separated by ultracentrifuation.
After 24 weeks of simvastatin administration, TC decreased by 25.7% (232.4±47.2mg/dl→172.6±32.9mg/dl) and low density lipoprotein cholesterol (LDL-C) decreased by 33.6% (151.0±36.9mg/dl→100.3±29.3mg/dl). These reductions were statistically significant. Triglyceride and HDL-C showed no significant changes. Apolipoprotein B significantly decreased, by 24.5% (115.4±20.6mg/dl→87.1±20.5mg/dl), and apolipoprotein E by 30.0% (6.9±2.8mg/dl→4.9±3.0mg/dl). No significant changes were observed in the other apolipoproteins. MDA was also significantly decreased, whereas Lp (a) was not significantly altered. In the lipoprotein fractions, very low density lipoprotein cholesterol (VLDL-C), intermediate density lipoprotein cholesterol (IDL-C), LDL1-C and LDL2-C showed significant decreases. No particular side effects were observed during the 12 months of simvastatin administration.
In conclusion, simvastatin appears to be safe and effective in HD patients with hypercholesterolemia.
