Effects of Statin Use in Advanced Chronic Kidney Disease Patients.
Although statin treatment is recommended for patients with chronic kidney disease (CKD) stages I⁻IV, its potential benefits have not been reported in advanced CKD patients. Non-diabetic patients with advanced CKD (pre-dialysis patients, estimated glomerular filtration rate <15 mL/min/1.73 m²) were enrolled from a National Health Insurance Research Database with a population of 23 million. Statin users and non-users were matched using propensity scoring and analyzed using Cox proportional hazards models, taking mortality as a competing risk with subsequent end-stage renal disease (ESRD) and statin doses as time-dependent variables. A total of 2551 statin users and 7653 matched statin non-users were identified from a total 14,452 patients with advanced CKD. Taking mortality as a competing risk, statin use did not increase the risk of new-onset diabetes mellitus (NODM) or decrease the risk of de novo major adverse cardiovascular events (MACE), but reduced all-cause mortality (hazard ratio (HR) = 0.59 [95% CI 0.42⁻0.84], p = 0.004) and sepsis-related mortality (HR = 0.53 [95% CI 0.32⁻0.87], p = 0.012). For advanced CKD patients, statin was neither associated with increased risks of developing NODM, nor with decreased risk of de novo MACE occurrence, but with a reduced risk of all-cause mortality, mainly septic deaths.
['Huang|Tao-Min|TM|0000-0002-9387-0798', 'Wu|Vin-Cent|VC|0000-0001-7935-0991', 'Lin|Yu-Feng|YF|0000-0002-4350-7755', 'Wang|Jian-Jhong|JJ|', 'Shiao|Chih-Chung|CC|0000-0003-2220-7574', 'Chen|Likwang|L|', 'Chueh|Shih-Chieh Jeff|SJ|', 'Chueh|Eric|E|', 'Yang|Shao-Yu|SY|', 'Lai|Tai-Shuan|TS|0000-0002-0552-372X', 'Lin|Shuei-Liong|SL|', 'Chu|Tzong-Shinn|TS|', 'Wu|Kwan-Dun|KD|', '|||']
statin chronic kidney disease mortality diabetes major adverse cardiovascular events sepsis