Investig Clin Urol.  2019 Nov;60(6):472-479. 10.4111/icu.2019.60.6.472.

Effects of short-term atorvastatin use in patients with calcium stones: A randomized placebo-controlled clinical trial

• Taheri F
• Taheri M
• Basiri A
• Khoshdel A
• Samadian F
• Tavasoli S

• KMID: 2461059
• DOI: http://doi.org/10.4111/icu.2019.60.6.472

Abstract

PURPOSE
A few experimental and observational studies have reported that atorvastatin prevents calcium oxalate stone formation. Our study is the first to investigate the effect of atorvastatin on 24-hour urinary metabolites, urinary malondialdehyde (U-MDA) (an oxidative stress marker) and urinary neutrophil gelatinase-associated lipocalin (U-NGAL) (a renal tubular injury marker) in patients with calcium stones and hyperoxaluria.
MATERIALS AND METHODS
This randomized, double-blind, placebo-controlled, parallel-group clinical trial included 32 adults with recurrent calcium stone formation and hyperoxaluria. All participants received a 3-month course of either atorvastatin (20 mg/d) or placebo of an identical shape. Both groups received the usual nutritional care based on the European Association of Urology guidelines.
RESULTS
Twenty-eight participants completed the study. Serum levels of total and low-density lipoprotein cholesterol decreased in the atorvastatin group, and these changes were significantly different between groups (p<0.001). No statistically significant differences were observed between intergroup changes of the 24-hour urinary metabolite analysis, the U-MDA to creatinine ratio and the U-NGAL to creatinine ratio.
CONCLUSIONS
Atorvastatin administration at a dose of 20 mg/d for 3 months did not affect 24-hour urinary metabolite, U-MDA and U-NGAL levels in recurrent calcium stone formers. However, this study could not disprove the preventive role of atorvastatin in kidney stone formation. Future studies should consider a larger sample size, longer follow-up, different drug doses, and measurements of multiple biomarkers of oxidative stress and tubular injury.

Keyword

Hydroxymethylglutaryl-CoA reductase inhibitors; Lipocalin-2; Malondialdehyde; Oxidative stress; Urolithiasis

MeSH Terms

Adult
Atorvastatin Calcium*
Biomarkers
Calcium Oxalate
Calcium*
Cholesterol
Creatinine
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hyperoxaluria
Kidney Calculi
Lipocalins
Lipoproteins
Malondialdehyde
Neutrophils
Oxidative Stress
Sample Size
Urolithiasis
Urology
Atorvastatin Calcium
Biomarkers
Calcium
Calcium Oxalate
Cholesterol
Creatinine
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Lipocalins
Lipoproteins
Malondialdehyde

Figure

• 

  Fig. 1 Participant flow diagram.

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