Little is known about the long-term effects of statin therapy in the development of kidney diseases. As such, University of California, San Francisco, researchers set out to determine if statin use is associated with incidence of acute and chronic kidney diseases after prolonged follow-up (mean of 6.19 years). They analyzed data from the San Antonio area military healthcare system from 2003 through 2012. Statin users were propensity score matched to non-users through 82 baseline characteristics, including demographics, medications, healthcare utilization, and comorbidities. Of the 43,438 patients included in the analysis, the team matched 6,342 statin users with 6,342 non-users. A matching analysis of 3,351 patients who were statin users for primary prevention and without significant comorbidities (healthy group) and 3,351 non-users with identical characteristics was also preformed. Among patients who were statin users, 73.5% were taking simvastatin (mean use 4.65 years) and nearly 38% were taking high-intensity statins. The study endpoints were nephritis/nephrosis/renal sclerosis, acute kidney injury, and chronic kidney disease.
The results revealed that statin-users had higher odds of AKI, and nephritis/nephrosis/renal sclerosis. Results from a subset of healthy patients without co-morbidities revealed that the association of statin use with CKD remained significant. In a secondary analysis, adjusting for diseases and conditions that developed during follow-up weakened this association. In the overall cohort, incidence of an outcome of interest was higher in those on high-intensity statins compared with patients on low-to moderate-intensity statins.
“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,” said Tushar Acharya, MD, of the division of cardiology, department of internal medicine, University of California, and the study’s first author, in recent news release.