Abstract
Few
studies have examined long-term effects of statin therapy on kidney
diseases. The objective of this study was to determine the association
of statin use with incidence of acute and chronic kidney diseases after
prolonged follow-up. In this retrospective cohort study, we analyzed
data from the San Antonio area military health care system from October
2003 through March 2012. Statin-users were propensity score matched to
non-users utilizing 82 baseline characteristics including demographics,
comorbidities, medications, and health care utilization. Study outcomes
were acute kidney injury (AKI), chronic kidney disease (CKD), and
nephritis/nephrosis/renal sclerosis. Of the 43,438 individuals included,
we propensity score-matched 6,342 statin-users with 6,342 non-users.
Statin-users had higher odds of AKI (odds ratio [OR] 1.30, 95%
confidence interval [95% CI] 1.14-1.48), CKD (OR 1.36, 95% CI
1.22-1.52), and nephritis/nephrosis/renal sclerosis (OR 1.35, 95% CI
1.05-1.73). In a subset of patients without co-morbidities, the
association of statin use with CKD remained significant (OR 1.53, 95% CI
1.27-1.85). In a secondary analysis, adjusting for diseases/conditions
that developed during follow-up weakened this association. In
conclusion, statin use is associated with increased incidence of acute
and chronic kidney disease. These findings are cautionary and suggest
that long-term effects of statins in real-life patients may differ from
shorter-term effects in selected clinical trial populations.
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