Assessment of the Effect of Statins on Carbohydrate and Lipid Metabolism and the Effectiveness of Hemodialysis in Patients With End-Stage Renal Disease

Objective: Nowadays, there is much debate about the advisability of using statins in patients with end-stage renal disease (ESRD) undergoing program hemodialysis (PH). The results of some studies indicate that, despite a significant reduction in plasma atherogenicity, the use of statins does not reduce mortality in these patients. The aim of this study was to evaluate the effect of statins on carbohydrate and lipid metabolism parameters and hemodialysis efficacy in patients with ESRD receiving PH therapy without a history of carbohydrate metabolism disorders. Design and method: The study included 40 patients with ESRD receiving PH.Two groups were considered: the main group – patients with ESRD receiving PH and 20 mg of atorvastatin therapy (n=20) and the comparison group – patients with ESRD receiving PH without statin therapy (n=20). The groups were comparable regarding gender, age, hemodialysis experience, and body mass index. In addition to the tests necessary to confirm the diagnosis, the following parameters were determined in all patients: spKT/V, fasting and postprandial glucose, C-peptide, insulin, glycated hemoglobin, fructosamine, insulin resistance index (HOMA), and lipid profile. Results: Fasting blood glucose, glycated hemoglobin, and fructosamine levels were significantly higher in patients receiving statins compared with those not receiving statins (5.87 ± 0.10 mmol/L vs. 4.60 ± 0.10 mmol/L, p <0.001; 6.08 ± 0.10% vs 5.33 ± 0.10%, p <0.001; 279.00 ± 21.10 mkmol/L vs 243.50 mkmol/L ± 19.10 p <0.05, respectively). There were no statistically significant differences in spKT/V levels between the groups. Analysis of lipid profile indicators showed lower levels of total cholesterol, triglycerides, and low-density lipoproteins in plasma in patients in the main group (5.0 ± 0.50 mmol/L vs. 6.5 ± 0.80 mmol/L, p < 0.001; 1.80±0.10 mmol/L vs. 2.5±0.18 mmol/L, p < 0.001; 3.95±0.05 mmol/L vs. 4.25±0.10 mmol/L, p < 0.05). Conclusions: The use of statins in patients with ESRD undergoing PH is associated with impaired carbohydrate metabolism. The use of statins in these patients led to an improvement in the lipid profile but did not affect the effectiveness of hemodialysis.