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STATINS FOR SECONDARY AND PRIMARY PREVENTION AND THE RISK OF KIDNEY DISEASE
A1442 JACC March 17, 2015 Volume 65, Issue 10S
Prevention Statins for Secondary and Primary Prevention and the Risk of Kidney Disease Poster Contributions Poster Hall B1 Sunday, March 15, 2015, 9:45 a.m.-10:30 a.m. Session Title: Statins, Cholesterol Guidelines and Lifestyle Abstract Category: 21. Prevention: Clinical Presentation Number: 1178-110 Authors: Tushar Acharya, Jian Huang, Steven Tringali, Christopher R. Frei, Eric M. Mortensen, Ishak Mansi, VA North Texas Health Care System, Dallas, TX, USA, University of California, San Francisco, Fresno, Fresno, CA, USA
Background: Statins are among the most widely prescribed medications for primary and secondary prevention of cardiovascular disease. The objective of this study was to determine the association of statin use and incidence of renal disease. Methods: In this retrospective cohort study, we analyzed data from patients in San Antonio area military health care system from 2003 through 2012. Baseline period of 10/1/2003 to 9/30/2005 was used to describe group characteristics. Using propensity score, statins users (who received a statin for ≥ 90 days) were matched to non-users utilizing 82 baseline characteristics including demographics, comorbidities, medications and health care utilization. Outcome events were defined as occurrence of predefined ICD-9 codes for acute kidney injury, chronic kidney disease and nephritis/nephrosis/renal sclerosis during the follow-up period (10/1/2005 to 3/1/2012).
Results: A total of 46,249 individuals met study criteria (13,626 statin users and 32,623 nonusers). Mean age of the study population was 56 years and 55% were males. Of these, we propensity matched 6967 statin users with 6967 nonusers. Among matched pairs, statin users had a higher risk of acute kidney injury (OR 1.30, 95% CI 1.14- 1.48, P<0.001), chronic kidney disease (OR 1.36, 95% CI 1.22 - 1.52, P<0.001), and nephritis/nephrosis/renal sclerosis (OR 1.35, 95% CI 1.05 - 1.73, P=0.018). In a healthy subset of patients (with Charlson comorbidity score of 0), the association of statin use and chronic kidney disease remained significant (OR 1.53; 95% CI 1.27 - 1.85; P<0.001).
Conclusion: Statin use is associated with increased incidence of acute and chronic kidney disease. These findings, though cautionary, need further confirmation and should not deter physicians from prescribing statins for their numerous well established benefits.
Prevention Statins for Secondary and Primary Prevention and the Risk of Kidney Disease Poster Contributions Poster Hall B1 Sunday, March 15, 2015, 9:45 a.m.-10:30 a.m. Session Title: Statins, Cholesterol Guidelines and Lifestyle Abstract Category: 21. Prevention: Clinical Presentation Number: 1178-110 Authors: Tushar Acharya, Jian Huang, Steven Tringali, Christopher R. Frei, Eric M. Mortensen, Ishak Mansi, VA North Texas Health Care System, Dallas, TX, USA, University of California, San Francisco, Fresno, Fresno, CA, USA
Background: Statins are among the most widely prescribed medications for primary and secondary prevention of cardiovascular disease. The objective of this study was to determine the association of statin use and incidence of renal disease. Methods: In this retrospective cohort study, we analyzed data from patients in San Antonio area military health care system from 2003 through 2012. Baseline period of 10/1/2003 to 9/30/2005 was used to describe group characteristics. Using propensity score, statins users (who received a statin for ≥ 90 days) were matched to non-users utilizing 82 baseline characteristics including demographics, comorbidities, medications and health care utilization. Outcome events were defined as occurrence of predefined ICD-9 codes for acute kidney injury, chronic kidney disease and nephritis/nephrosis/renal sclerosis during the follow-up period (10/1/2005 to 3/1/2012).
Results: A total of 46,249 individuals met study criteria (13,626 statin users and 32,623 nonusers). Mean age of the study population was 56 years and 55% were males. Of these, we propensity matched 6967 statin users with 6967 nonusers. Among matched pairs, statin users had a higher risk of acute kidney injury (OR 1.30, 95% CI 1.14- 1.48, P<0.001), chronic kidney disease (OR 1.36, 95% CI 1.22 - 1.52, P<0.001), and nephritis/nephrosis/renal sclerosis (OR 1.35, 95% CI 1.05 - 1.73, P=0.018). In a healthy subset of patients (with Charlson comorbidity score of 0), the association of statin use and chronic kidney disease remained significant (OR 1.53; 95% CI 1.27 - 1.85; P<0.001).
Conclusion: Statin use is associated with increased incidence of acute and chronic kidney disease. These findings, though cautionary, need further confirmation and should not deter physicians from prescribing statins for their numerous well established benefits.