***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND We previously reported urinary podocytes to be a marker of glomerular injury . The aim of the present study was to determine whether cerivastatin , a newly developed , potent synthetic statin , affects proteinuria and urinary podocyte excretion in patients with chronic glomerulonephritis ( CGN ) . METHODS We r and omly assigned 40 normotensive hypercholesterolemic patients with CGN to receive either cerivastatin 0.15 mg/day ( n=20 ) or placebo ( n=20 ) . Subjects comprised 24 men and 16 women , with a mean age of 40.8+/-14.4 years ; 27 had IgA nephropathy and 13 had non-IgA proliferative glomerulonephritis . Treatment was continued for 6 months . Plasma total cholesterol , HDL-cholesterol , LDL-cholesterol and triglycerides , urinary protein excretion and the number of podocytes were measured before treatment and at 3 and 6 months after treatment . RESULTS After 6 months , a significant reduction in total cholesterol ( P<0.001 ) , LDL-cholesterol ( P<0.001 ) and triglycerides ( P<0.05 ) , and a significant increase in HDL-cholesterol ( P<0.001 ) were observed in the group treated with cerivastatin .  Urinary protein excretion decreased from 1.8+/-0.6 to 0.8+/-0.4 g/day , ( P<0.01 ) in this group , and urinary podocyte excretion decreased from 1.6+/-0.6 to 0.9+/-0.4 cells/ml ( P<0.01 ) . However , placebo showed little effect on these lipid levels , urinary protein excretion and urinary podocyte excretion . The differences between the cerivastatin group and the placebo group were significant ( cholesterol , P<0.001 ; LDL-cholesterol , P<0.001 ; triglycerides , P<0.05 ; HDL-cholesterol , P<0.001 ; urinary protein , P<0.01 ; and urinary podocytes , P<0.01 ) . CONCLUSION Statins such as cerivastatin may be beneficial for restoration of injured podocytes in patients with CGN and hypercholesterolaemia In this study 43 patients with idiopathic nephrotic syndrome were r and omly distributed into 2 age- and sex-matched groups . The first group was given fluvastatin while the second was used as control . The cases in the 2 groups were evaluated clinical ly , biochemically ( creatinine clearance , albumin , 24-hour proteinuria , and lipogram ) , neurologically , and histopathologically ( examination of renal biopsies obtained basally and after 1 year of treatment with fluvastatin ) . In the fluvastatin-treated group but not in the control group , we observed a significant reduction in cholesterol , low-density lipoprotein , and triglyceride . Clinical and laboratory assessment showed satisfactory tolerance of the drug by the patients . Proteinuria , serum albumin and creatinine clearance values were significantly better in the statin-treated patients . There was no difference in glomerular sclerosis between the 2 groups while interstitial fibrosis and renal fat deposits were less in the statin-treated group . The reduction in renal fat deposits in the statin-treated group was highly significant , while that of interstitial fibrosis was not . We conclude that : ( 1 ) statin can be safely and effectively used in the treatment of dyslipidemia in patients with persistent idiopathic nephrotic syndrome ; ( 2 ) control of dyslipidemia in nephrotic patients is associated with better control of proteinuria and creatinine clearance ; ( 3 ) statin treatment may cause regression of renal fat deposits in patients with nephrotic syndrome , and ( 4 ) longer term studies are still required to study further possible beneficial effects on renal histology and disease progression BACKGROUND Recipients of renal transplantation ( RT ) exhibit disturbances of serum lipids and apoproteins that may contribute to their cardiovascular morbidity and mortality . In our renal transplant department the hypercholesterolaemia prevalence at the first and fifth year of RT is 70.0 % and 81.2 % , respectively . Lipid-lowering therapy has been utilized in many Transplant Units . The aim of our study was to evaluate post-RT hyperlipidaemia control with simvastatin or fish oil . METHODS Forty-three RT patients ( 26 men and 17 women ) with persistent hypercholesterolaemia and stable graft function which were resistant to a lipid-lowering diet ( American Heart Association Step Two ) were r and omized into two groups and treated for 3 months with simvastatin ( S ) ( 10mg/day ; n = 25 ) and fish oil ( F ) ( 6 g/day ; n = 18 ) . Total cholesterol ( TC ) , LDL-cholesterol ( LDL-C ) , HDL-cholesterol ( HDL-C ) , lipoprotein a ( Lp(a ) ) , apolipoprotein A1 ( Apo A1 ) , and apolipoprotein B ( Apo B ) were monitored and at the study baseline they were similar between the two groups . RESULTS No side effects were detected after 3 months of therapy . In group S , the concentrations of TC ( 271 + /- 46 mg% vs 228 + /- 49 mg% ; P < 0.001 ) , TG ( 180 + /- 78 vs 134 + /- 45 ; P < 0.01 ) , LDL-C ( 177 + /- 40 vs 144 + /- 43 ; P < 0.01 ) and Apo B ( 96 + /- 18 vs 82 + /- 16 ; P < 0.001 ) were significantly reduced , and Apo A1 concentration had increased ( 135 + /- 24 vs 149 + /- 30 ; P < 0.01 ) . In group F , the concentrations of TC ( 266 + /- 25 vs 240 + /- 31 ; P < 0.001 ) , TG ( 203 + /- 105 vs 156 + /- 72 ; P = 0.02 ) and HDL-C ( 63 + /- 15 vs 53 + /- 12 ; P < 0.01 ) were significantly reduced . CONCLUSIONS We concluded that low-dose simvastatin and fish oil are both effective and safe in correcting post-RT hyperlipidaemia . Further prospect i ve studies with larger follow-up are needed to clarify whether this therapy has an impact on cardiovascular morbidity and mortality in RT patients Background : Little is known about statins in the prevention of  dyslipidaemia induced renal function decline . The secondary coronary heart disease ( CHD ) prevention GREACE study suggested that dose titration with atorvastatin ( 10–80 mg/day , mean dose 24 mg/day ) achieves the national cholesterol educational programme treatment goals and significantly reduces morbidity and mortality , compared with usual care . Aims : To report the effect of statin on renal function compared with untreated dyslipidaemia in both treatment groups . Methods / Results : All patients had plasma creatinine values within the reference range < 115 µmol/litre ( 13 mg/litre ) .  The on study creatinine clearance ( CrCl ) , as estimated ( for up to 48 months ) by the Cockroft-Gault formula , was compared within and between treatment groups using analysis of variance to assess differences over time . Patients from both groups not treated with statins ( 704 ) showed a 5.2 % decrease in CrCl ( p < 0.0001 ) . Usual care patients on various statins ( 97 ) had a 4.9 % increase in CrCl ( p = 0.003 ) . Structured care patients on atorvastatin ( 783 ) had a 12 % increase in CrCl ( p < 0.0001 ) . This effect was more prominent in the lower two quartiles of baseline CrCl and with higher atorvastatin doses . After adjustment for 25 predictors of all CHD related events , multivariate analysis revealed a hazards ratio of 0.84 ( confidence interval 0.73 to 0.95 ; p = 0.003 ) with every 5 % increase in CrCl . Conclusions : In untreated dyslipidaemic patients with CHD and normal renal function at baseline , CrCl declines over a period of three years . Statin treatment prevents this decline and significantly improves renal function , potentially off setting an additional factor associated with CHD risk The high prevalence of hypercholesterolemia in kidney transplant recipients probably contributes to the high cardiovascular mortality in these patients . Except for diet , there is no generally recommended cholesterol-lowering treatment . We conducted a double-blind , r and omized , placebo-controlled study with low-dose simvastatin in 40 ciclosporin (CS)-treated kidney transplant recipients during 16 weeks , focusing on side effects and dose finding . In the simvastatin group , the mean serum total and LDL cholesterol concentrations decreased by 23 and 33 % , respectively , and the mean serum HDL cholesterol concentration increased by 12 % , after 4 weeks of treatment with simvastatin 10 mg daily . Increasing the dose to 20 mg daily in a few patients only result ed in marginal further reductions of the serum cholesterol concentrations at the expense of doubling the plasma simvastatin 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitory activity concentrations . The differences between the changes in the serum cholesterol concentrations in the simvastatin group and the negligible changes in the placebo group were statistically significant . There was no case of proximal myopathy and the serum creatine kinase concentrations did not differ between treatment groups . In conclusion , low-dose simvastatin appears to be a well tolerated and efficacious cholesterol-lowering treatment in CS-treated kidney transplant recipients .  Simvastatin 10 mg daily seems to be the most suitable dose for the majority of these patients Background : With current techniques , renal failure patients are now able to regain near‐normal health following renal transplantation . However , the development of premature cardiovascular disease is a major problem . Dyslipidaemia may be an important contributor to this . The use of lipid lowering agents in renal allograft recipients has been limited by potential interaction of these agents with the now widely used immunosuppressive agent , cyclosporine . Aim : This study was design ed to investigate efficacy and safety of simvastatin in subjects taking either cyclosporine or azothioprine post renal transplantation . Methods : Fifty‐one subjects ( 32 females , 19 males – mean age 51±12.5 yr ) who were at least 1 yr post transplant , had creatinine ≤2.5 mmol/L and a total cholesterol ≥6 mmol/L were enrolled in a prospect i ve , double‐blind , placebo‐controlled study . After an initial 10‐wk dietary period , the last 4 wk on placebo , subjects were r and omised to receive either 5 mg simvastatin/d for 6 wk followed by 10 mg simvastatin/d for 6 wk , or matching placebo . After this 12‐wk double‐blind phase , there was an open‐label phase when all subjects were treated with 10 mg simvastatin/d for a period of 36 wk . Results : Compared to placebo , 5 mg simvastatin/d significantly decreased total cholesterol by 20 % ( p<0.01 ) , low‐density lipoprotein cholesterol ( LDL cholesterol ) by 29 % ( p<0.01 ) , and Apolipoprotein B ( ApoB ) by 26 % ( p<0.01 ) . Increasing simvastatin to 10 mg/d did not lead to further significant changes . But high‐density lipoprotein cholesterol ( HDL cholesterol ) increased by 9 % ( p<0.01 ) and Apolipoprotein A1 ( ApoA1 ) by 7 % ( p<0.01 ) only on 10 mg simvastatin/d . During the open‐label phase , subjects previously r and omised to placebo achieved similar significant changes to their lipoprotein profile . The benefits achieved from simvastatin were maintained to the end of the study . There were three withdrawals from the study , all from the simvastatin/cyclosporine  group . Two subjects had musculoskeletal pain and 1 had abdominal pain . Minor adverse events were similar in both the simvastatin‐ and placebo‐treated groups . Conclusion : Low‐dose simvastatin is an effective and well‐tolerated agent in the treatment of dyslipidaemia in renal allograft recipients Lipid abnormalities are seen frequently in renal transplant patients . Cardiovascular disease is an important cause of morbidity and mortality in these patients . We assessed the efficacy and safety of the lipid-lowering drugs , nicotinic acid ( short acting ) and lovastatin , the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor .  Twelve renal transplant patients who had persistent hyperlipidemia despite 6 weeks of diet 
    Output:
    
There is no enough evidence to suggest that statins are associated with a significant reduction in the risk of serum creatinine doubling or of end-stage renal disease in CKD patients ( evidence from SR and RCT ) .
Statins compared to placebo or no treatment are associated with significant improvements in proteinuria ( evidence from SR ) .
Statins are also associated with significant reduction in the risk of cardiovascular events and mortality in CKD patients ( evidence from SR and RCT ) and in renal transplant recipients ( evidence from RCT ) , and no significant increases in the risk of rhabdomyolysis and hepatotoxicity in CKD patients .
Available evidence supports the hypothesis that statins should be recommended in CKD patients ( non-dialysis patients ) on the basis of significant evidence of cardiac and renal protection and no evidence of significant harms .