Statin use among Veterans with dialysis‐dependent chronic kidney disease

Abstract

Introduction: The benefits of statin medications in patients receiving maintenance dialysis remains controversial and clinical trials overall have shown no benefit. Potential side effects of statin medications include myalgias, myopathy, and memory loss and risk of side effects associated with statin medications increase with higher statin doses. We examined statin use and statin dose among Veterans with dialysis dependent CKD. Such information may help clinicians modulate medication use and reduce pill burden in appropriate patients. Methods: This cross‐sectional analysis ascertained medication utilization by linking records from the U.S. Department of Veteran's Affairs (VA) Managerial Cost Accounting Pharmacy National Data Extracts and Medicare Part D during calendar year 2013 for Veterans with dialysis‐dependent CKD enrolled in and/or using VA healthcare. The venue of dialysis and patient characteristics were ascertained by linking VA Medical SAS datasets, VA Fee Basis datasets (for non‐VA care paid for by VA), Medicare claims and the United States Renal Data Systems patient core files. Findings: We identified 18,494 Veterans with dialysis‐dependent CKD who were enrolled in and/or used VA healthcare, had no history of kidney transplantation, and were alive on January 1, 2014. More than half (58.1%) of Veterans with dialysis‐dependent CKD used statins and 35.7% of statin utilization was high dose. Statins were the third most commonly prescribed medication after beta blockers (64.8%) and phosphate binders (64.5%). Discussion: Statins are a commonly prescribed medication among Veterans receiving maintenance dialysis and approximately one‐third of statin utilization is high dose in this population. Future studies should examine patient preferences, comorbidities, and dialysis characteristics that impact the risks and benefits of statin use in order to identify those patients who will or will not benefit from continued statin use.

Statins and cognition: Modifying factors and possible underlying mechanisms

“…Chronic kidney disease (CKD) increases the risk of dementia, damages the cerebrovascular system, and promotes WMH in the prefrontal cortex in animal models ( Viggiano et al, 2020 ). The beneficial effects of statin therapy for CVD in patients with CKD remain controversial, and the cognitive effect of statins is rather unknown in the CKD population ( Markossian et al, 2019 ). Recently, Zijlstra et al (2020) investigated the association between kidney function and cognitive decline in older adults at high risk of CVD, using data from the Prospective Study of Pravastatin in the Elderly at Risk (PROSPER).…”

Fermented Cerasus humilis fruits protect against high‐fat diet induced hyperlipidemia which is associated with alteration of gut microbiota

“…8 However, recent studies have disclosed potential health and safety hazards related to prolonged statin administration, including myalgias, myopathy and memory loss. 9 A few studies confirmed that the nutrients and secondary metabolites in plant fermentation broth are potently antioxidant and can restore health by improving antioxidant capacity, restoring oxidation/ antioxidant homeostasis and lowering lipid levels. 10 Plant fermentation broth is rich in polyphenols, flavonoids and probiotics.…”