Association of Statin Use With Mortality After Dialysis-Requiring Acute Kidney Injury: A Population-Based Cohort Study

Mayo Clin Proc. 2018 Oct;93(10):1474-1483. doi: 10.1016/j.mayocp.2018.05.034.

Abstract

Objective: To investigate the association between statin use and mortality in patients with dialysis-requiring acute kidney injury (AKI-D).

Patients and methods: This nationwide, population-based, retrospective cohort study included 6091 hospitalized patients with AKI-D (1271 statin users and 4820 statin nonusers) retrieved from the National Health Insurance Research Database of Taiwan between January 1, 2000, and December 31, 2012. All the patients were followed up until December 31, 2013. Primary and secondary outcomes were 1-year and in-hospital mortality, respectively. All the primary analyses were performed using the intention-to-treat approach.

Results: During 1-year follow-up, 492 of 1271 statin users (38.7%) and 2365 of 4820 statin nonusers (49.1%) died. After propensity score matching, statin use was independently associated with lower risks of 1-year all-cause mortality (hazard ratio [HR], 0.79; 95% CI, 0.69-0.9; P<.001) and in-hospital all-cause mortality (HR, 0.84; 95% CI, 0.71-0.99; P=.04). The survival benefit of statin treatment was dose-dependent and consistent across subgroups based on sensitivity analyses.

Conclusion: Statin use was independently associated with reduced risks of 1-year and in-hospital mortality in patients with AKI-D. Statin therapy may be beneficial in this patient group. However, further clinical trials should be performed to confirm the findings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / therapy
  • Aged
  • Cause of Death
  • Dose-Response Relationship, Drug
  • Female
  • Follow-Up Studies
  • Hospital Mortality
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects
  • Hyperlipidemias* / drug therapy
  • Hyperlipidemias* / epidemiology
  • Male
  • Middle Aged
  • Mortality
  • Population Surveillance
  • Renal Dialysis* / methods
  • Renal Dialysis* / statistics & numerical data
  • Retrospective Studies
  • Survival Analysis
  • Taiwan / epidemiology

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors