|Title:||Effects of Statin Use in Advanced Chronic Kidney Disease Patients||Authors:||Huang, Tao-Min
Chueh, Shih-Chieh Jeff
Wu, Kwan Dun
|Keywords:||chronic kidney disease; diabetes; major adverse cardiovascular events; mortality; sepsis; statin||Issue Date:||17-Sep-2018||Publisher:||MDPI||Journal Volume:||7||Journal Issue:||9||Start page/Pages:||285||Source:||Journal of clinical medicine||Abstract:||
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.
|Appears in Collections:||醫學教育暨生醫倫理學科所|
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