Diabetic nephropathy is commonly associated with dyslipidemia, but the role of lipids in the progression of this disorder
remains unresolved. In particular, the role of lipid-lowering drugs, such as 3-hydroxy-3-methylglutaryl coenzyme A reductase
inhibitors and fibrates, as renoprotective agents is not clarified. Experimental studies have demonstrated that dietary lipids
promote renal injury and that statins, independent of their lipid-lowering effects, confer renoprotection via effects on intrarenal
hemodynamics and renal cytokine and chemokine expression. Clinical studies have in general been underpowered, but a recent
meta-analysis and findings from the Heart Protection Study suggest that statins may be renoprotective. Nevertheless, with
the convincing antiatherosclerotic effects of these agents, including in the setting of diabetes, they should be widely administered
in the diabetic population with or at risk for nephropathy.