Influence of statin‐potency on the risk of kidney disease – A nationwide cohort study using laboratory data

Abstract

PurposeTo estimate the risk of kidney disease in high‐potency statin users compared to those treated with low‐potency statins without history of kidney disease at statin initiation, linking the Swedish national healthcare registers and laboratory data.MethodsIncident users of statins, ≥40 years of age, with estimated Glomerular Filtration Rate (eGFR) >60 ml/min/1.73 m2 and no diagnosis of kidney disease at treatment initiation were identified between 2006 and 2007 and then followed for 2‐years. The outcome was the incidence of kidney disease identified by the presence of the diagnostic code in the healthcare registers or eGFR <60 ml/min/1.73 m2. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) with adjusted and propensity score (PS)‐matched Cox proportional hazards models.ResultsA total of 27 385 patients were identified, 25.2% of which treated with a high‐potency statin. During the follow‐up, 68 (0.25%) patients were identified with a diagnosis of kidney disease from the registers. The number increased to 2498 (9.1%) when the criteria of eGFR <60 ml/min/1.73 m2 was added. The adjusted HR of kidney disease in high‐potency statin users was 1.14 (95%CI 1.03–1.25) compared to low‐potency users; the result was unchanged after the PS approach.ConclusionsAdding information from laboratory data to those from the national health registers, a slightly increased risk for kidney disease was found in high‐potency statin users without pre‐existing kidney disease at treatment initiation compared to those treated with low‐potency statins.

Effect of Statins on All-Cause Mortality in Adults: A Systematic Review and Meta-Analysis of Propensity Score-Matched Studies

“…There is evidence that statins might also have nephroprotective effects and slow the progression of CKD (a slower decline in glomerular filtration rate among statin users) [ 78 ]. However, other studies found that high-dose statin therapy, as compared with low-dose therapy, was associated with an increased risk of kidney disease [ 79 ]. The anti-inflammatory and antioxidant effects of statins can be beneficial in patients with autoimmune diseases [ 80 ].…”