Effects of pitavastatin add-on therapy on chronic kidney disease with albuminuria and dyslipidemia

BACKGROUND: In non-dialysis chronic kidney disease (CKD) patients with dyslipidemia, statin therapy is recommended to prevent cardiovascular complications. Dyslipidemia has been also shown to be an independent risk factor for the progression of CKD. However, it is still unclear whether statin therapy exerts an inhibitory effect on renal deterioration in CKD patients with dyslipidemia. The purpose of the present study was to examine possible therapeutic effects of statin add-on therapy on renal function as well as parameters of lipid and glucose metabolism, arterial stiffness and oxidative stress, in comparison to diet therapy, in CKD patients with dyslipidemia. METHODS: This study was a randomized, open-label, and parallel-group trial consisted of a 12-months treatment period in non-dialysis CKD patients with alubuminuria and dyslipidemia. Twenty eight patients were randomly assigned either to receive diet counseling alone (diet therapy group) or diet counseling plus pitavastatin (diet-plus-statin therapy group), to achieve the LDL-cholesterol (LDL-C) target of <100 mg/dl. RESULTS: The statin treatment by pitavastatin was well tolerated in all of the patients without any significant adverse events and the average dose of pitavastatin was 1.0 ± 0.0 mg daily after treatment. After the 12-months treatment period, LDL-C was significantly lower in the diet-plus-statin therapy group compared with the diet therapy group (diet vs diet-plus-statin: LDL-C, 126 ± 5 vs 83 ± 4 mg/dL, P < 0.001). On the other hand, the diet-plus-statin therapy did not significantly reduce albuminuria or delay the decline in eGFR compared with the diet therapy, and there was no relationship between the change in LDL-C and the change in eGFR or albuminuria. However, diet therapy as well as diet-plus-statin therapy exerted similar lowering effects on the pentosidine levels (diet therapy group, baseline vs 12 months: 40 ± 4 vs 24 ± 3 ng/mL, P = 0.001; diet-plus-statin therapy, 46 ± 7 vs 34 ± 6 ng/mL, P = 0.008). Furthermore, the results of multivariate regression analysis indicated that the change in pentosidine was a significant contributor to the change in eGFR (β = −0.536, P = 0.011). CONCLUSIONS: Although statin add-on therapy did not show additive renal protective effects, the diet therapy as well as the diet-plus-statin therapy could contribute to the reduction in plasma pentosidine in CKD patients with albuminuria and dyslipidemia

Mechanical properties and microstructure of AZ31B magnesium alloy processed by I-ECAP

Incremental equal channel angular pressing (I-ECAP) is a severe plastic deformation process used to refine grain size of metals, which allows processing very long billets. As described in the current article, an AZ31B magnesium alloy was processed for the first time by three different routes of I-ECAP, namely, A, Bc, and C, at 523 K (250 °C). The structure of the material was homogenized and refined to ~5 microns of the average grain size, irrespective of the route used. Mechanical properties of the I-ECAPed samples in tension and compression were investigated. Strong influence of the processing route on yield and fracture behavior of the material was established. It was found that texture controls the mechanical properties of AZ31B magnesium alloy subjected to I-ECAP. SEM and OM techniques were used to obtain microstructural images of the I-ECAPed samples subjected to tension and compression. Increased ductility after I-ECAP was attributed to twinning suppression and facilitation of slip on basal plane. Shear bands were revealed in the samples processed by I-ECAP and subjected to tension. Tension–compression yield stress asymmetry in the samples tested along extrusion direction was suppressed in the material processed by routes Bc and C. This effect was attributed to textural development and microstructural homogenization. Twinning activities in fine- and coarse-grained samples have also been studied