ADDING NIACIN WITH ATORVASTATIN IN PATIENTS WITH RENAL ISCHEMIA: A COMPARATIVE STUDY

The study was aimed to compare the effect of lipid lowering only through Atorvastatin and lipid lowering combined with HDL-C raise by adding Niacin on the lipid profile and renal outcomes in renovascular disease. It was prospective, analytical hospital based study. In diagnosed patients Atorvastatin (20mg) and/or in combination with Niacin Extended Release 500mg/day was prescribed randomly distributed in two groups of equal size (n=60) for four months. 50 healthy individuals were also added to get local reference values. Pre and post treatment lipid profile and Apo A-1 were measured and analyzed using t-test at alpha 0.05. There was no difference in the baseline values. Atorvastatin induced a significant reduction in total cholesterol (p<0.05) and LDL (p<0.05), while decrease in TG and vLDL levels remained insignificant. It also causes an increase in HDL (p<0.05) and Apo A1 that was non-significant. Atorvastatin combined with NER reduced cholesterol (p<0.05), TG (p<0.05), LDL (p<0.05) enhanced HDL (p<0.0001) and Apo A1 (p<0.01). The inter-group comparison of both treatments demonstrated relatively better outcomes following Atorvastatin NER combination in terms of good cholesterol (p<0.01) for HDL and (p<0.01) for Apo A1, while in term of lipid lowering potentials, we found no difference. Addition of NER to statin has beneficial effect on lipid profile even at a comparatively low dose of 500mg and well tolerated in renovascular disease patient. This combination may be used to prevent further systemic complications in this group of patients.