Evaluation of the effects of simvastatin in reduction of panel-reactive antibody (PRA) levels in patients with end-stage renal disease awaiting renal transplantation

This study was undertaken to assess the effect of simvastatin in the reduction of panel-reactive antibody (PRA) levels in patients with end-stage renal disease (ESRD) awaiting renal transplantation. During the 1-year period from September 2007 to August 2008,60 ESRD patients with PRA levels more than 30% were enrolled into the study. Each patient was given oral simvastatin 10 mg/day as the initial dose. After one month,in those patients who did not respond,the dose was increased to 20 mg/day. Again,at the end of two months,if there was no response,the dose was further raised to 40 mg/day of simvastatin. The appropriate response to the treatment was defined as serum PRA levels getting reduced to less than 30%. Among the 60 patients who were enrolled in the study,three cases were excluded due to side-effects of the drug and 57 patients remained in our study. The mean age was 42.8 ± 28.2 years (range 18-75). Among these,34 (59.6%) were females. Before the study,the PRA levels were between 30 and 100 (mean ± SD: 60.4% ± 20%). After the administration of simvastatin,a significant decrease in PRA levels was seen in our patients (P 0.0001). In patients who had baseline PRA less than 40%,the PRA dropped to below 30% in 69.2% of the cases with 10 mg simvastatin. In those who had baseline PRA more than 40%,a similar reduction was seen only in 15.9% of the cases. However,in those who did not respond initially to 10 mg of simvastatin,statistically significant reductions were seen after the administration of 20 mg and,if needed,40 mg of simvastatin (P = 0.001). In conclusion,simvastatin can be a useful drug in ESRD patients to lower the PRA levels.