Effect of Acute Versus Gradual Dosing Of Atorvastatin Regarding Liver Enzymes In Chronic Renal Patients

Background and Aim: Patient with Chronic Renal disease (CKD) had progression related to poor health outcomes, increased cardiovascular complications, early death, and kidney failure. The main therapy for the prevention of atherosclerosis and cardiovascular disease (CVD) is Atorvastatin for reducing hypercholesteremia. We aim to determine the effect of acute versus gradual dosing of atorvastatin regarding liver enzymes in chronic renal patients.Methodology: This study was directed between March 2023 and October 2023 and one hundred and two patients were selected. There were two groups of people (51 in each): Group (A) on high-dose atorvastatin (80 mg) from the start. And Group (B) was on low introduction dose of atorvastatin (5 mg) then the dose increased every 4 weeks by 10 mg. The study lasted for 6 months from the dose of the maximum tolerated statin. Group (A) of high-intensity atorvastatin was persisting for six months. Results: About 102 patients; they are 61 males (59.8 percent) and 41 females (40.2 percent) with a mean age of 58.25 ± 10.34; underwent several analyses. We found that the two groups of atorvastatin (high-dose and low introduction dose) are showing a significant difference on the liver follow-up profile (ALT, AST) (P-value = 0.007, 0.000 respectively).Conclusion: Gradual initiation of Atorvastatin therapy is better tolerated than immediate high-dose Atorvastatin therapy in chronic kidney disease patients. These results support starting with low-dose Atorvastatin and gradually increasing the dose to improve Atorvastatin tolerance and protect liver function.