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KMID : 1011820190600060472
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Investigative and Clinical Urology
2019 Volume.60 No. 6 p.472 ~ p.479
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Effects of short-term atorvastatin use in patients with calcium stones: A randomized placebo-controlled clinical trial
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Taheri Fatemeh
Taheri Maryam
Basiri Abbas
Khoshdel Alireza
Samadian Fariba
Tavasoli Sanaz
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Abstract
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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.
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KEYWORD
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Hydroxymethylglutaryl-CoA reductase inhibitors, Lipocalin-2, Malondialdehyde, Oxidative stress, Urolithiasis
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