Objectives Statins can significantly improve the lipid profile and reduce cardiovascular events. But safety of statins on renal function is still controversial.

Methods Pubmed, the Cochrane Central Register of Controlled Trials and ClinicalTrials.gov website were searched for published or unpublished randomised, controlled trials. The selected studies reported estimated glomerular filtration rate (eGFR), proteinuria and/or albuminuria during treatment with statins vs control, or rosuvastatin vs atorvastatin. Thirty-six eligible studies with a total of 20,059 participants were included in this analysis.

Results Ascompared with pravastatin group, there was a significant reduction in eGFR in control group (standard mean difference [SMD]: 0.05, 95% confidence interval [CI]: 0.01 to 0.08, P<0.05). Meanwhile, in pravastatin-treated group a reduction in proteinuria was statistically significant (SMD: -1.89, 95% CI: -3.31 to -0.48, P<0.05). No significant difference in eGFR, albuminuria and proteinuria was detected in fluvastatin vs control, rosuvastatin vs control, atorvastatin vs control, simvastatin vs control and rosuvastatin vs atorvastatin.

Conclusions Pravastatin appears to reduce the decline of eGFR and decrease proteinuria moderately.