|Title:||Effects of Statin Use in Advanced Chronic Kidney Disease Patients||Authors:||TAO-MIN HUANG
National Taiwan University Hospital Study Group on Acute Renal Failure (NSARF)
|Keywords:||chronic kidney disease; diabetes; major adverse cardiovascular events; mortality; sepsis; statin;Chronic kidney disease; Diabetes; Major adverse cardiovascular events; Mortality; Sepsis; Statin||Issue Date:||17-Sep-2018||Journal Volume:||7||Journal Issue:||9||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.
|URI:||https://scholars.lib.ntu.edu.tw/handle/123456789/575652||ISSN:||2077-0383||DOI:||10.3390/jcm7090285||SDG/Keyword:||antianemic agent; atorvastatin; fluindostatin; hydroxymethylglutaryl coenzyme A reductase inhibitor; mevinolin; pravastatin; rosuvastatin; simvastatin; adult; all cause mortality; Article; cardiovascular disease; cerebrovascular accident; chronic kidney failure; cohort analysis; comorbidity; controlled study; coronary angiography; coronary artery bypass graft; diabetes mellitus; dialysis; end stage renal disease; female; follow up; glomerulus filtration rate; heart infarction; human; hyperglycemia; infection; kidney transplantation; major clinical study; male; middle aged; retrospective study; sepsis; treatment outcome
|Appears in Collections:||醫學系|
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