LIPID-LOWERING THERAPY IN CHRONIC KIDNEY DISEASE: EFFECTS ON LIPID PROFILES, OXIDATIVE STRESS, AND TRYPTOPHAN DEGRADATION

Abstract

Background: Chronic kidney disease (CKD) is a progressive condition associated with high cardiovascular risk, oxidative stress, and inflammation. Dyslipidemia is a common comorbidity in CKD, contributing to disease progression and complications. However, the effects of different lipid-lowering therapies on lipid profiles, oxidative stress, and inflammatory markers in CKD remain unclear. Objectives: This study aimed to evaluate the effects of three lipid-lowering regimens: simvastatin monotherapy (40 mg/day) and combination therapy with ezetimibe/simvastatin (10/20 mg and 10/40 mg) on lipid profiles, oxidative stress indices, and inflammatory markers in patients with CKD stage 3-4. Materials and Methods: A 12-month prospective study was conducted on CKD patients receiving one of the three lipid-lowering regimens. Lipid parameters, oxidative stress markers (MDA, PSH, PON, TEAC), and inflammatory markers (Kyn, Kyn/Trp ratio) were measured at baseline and after treatment. Statistical analysis was performed to determine correlations between LDL-C, oxidative stress, and inflammation. Results: All three treatment regimens significantly improved lipid profiles, reduced oxidative stress (lower MDA, higher PSH, PON, TEAC), and decreased inflammation (lower Kyn, Kyn/Trp ratio). The ezetimibe/simvastatin 10/40 mg combination showed the most pronounced improvements, although differences were not statistically significant. LDL-C levels positively correlated with MDA, Kyn, and Kyn/Trp ratio, suggesting that LDL-C reduction contributes to decreased oxidative stress and inflammation. Conclusion: Lipid-lowering therapy effectively improves lipid metabolism, oxidative stress, and inflammation in CKD stage 3-4 patients. Combination therapy with higher doses of Simvastatin may offer additional benefits.