Estatinas e microalbuminúria
Palavras-chave:
microalbuminúria, estatinas, dislipidemia, nefropatiaResumo
A microalbuminúria é, actualmente, considerada um indicador de risco cardiovascular,
ocorrendo frequentemente associada a outros
factores de risco aterosclerótico e podendo representar o marcador renal do aumento generalizado da permeabilidade endotelial que acompanha o processo aterogénico. Segundo
alguns estudos, a prevalência da microalbuminúria na população geral varia entre 3,8 e
14,6%, verificando-se prevalências mais elevadas nos diabéticos e ou hipertensos.
Evidências histopatológicas e experimentais
sugerem que a dislipidemia pode iniciar e contribuir para a progressão da nefropatia, sendo os mecanismos implicados semelhantes aos envolvidos na aterosclerose; por outro lado, a
perda urinária de albumina pode levar a elevação dos níveis plasmáticos das lipoproteínas
A terapêutica hipolipemiante com estatinas demonstrou reduzir o risco cardiovascular e,
também, melhorar a função endotelial. Estudos
em animais e in vitro demonstraram efeitos
benéficos destes fármacos em vários modelos de nefropatia, incluindo reduções da excreção
urinária de proteínas. Alguns estudos realizados em doentes com excreção anormal de proteínas na urina apoiam a hipótese de que os efeitos renoprotectores também ocorram em humanos, continuando, ainda em aberto, no
entanto, o campo para investigação nesta área, particularmente sobre o efeito das estatinas na redução da microalbuminúria.
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