High potency statins and rates of admission for acute kidney injury (Q10-D2)

High potency statins and rates of admission for acute kidney injury (Q10-D2)

Q10-D2

Overview

What is the issue?
  • Statins are effective cholesterol-lowering drugs, but their use has been linked to sudden loss of kidney function, or AKI.
What was the aim of the study?
  • This study explored the association between high potency statins and AKI in patients with and without chronic kidney disease, compared to patients using low potency statins.
How was the study conducted?
  • We conducted nine population-based cohort studies and a meta-analysis with health records from seven Canadian provinces and two international databases. The study included over 2 million patients, aged 40 years or older and newly treated with a statin.
  • Our investigators performed as-treated, nested case-control analyses in cohorts of patients without chronic kidney disease and with chronic kidney disease to measure hospitalization rates for AKI in users of high vs. low potency statins.
What did the study find?
  • About 1 in 500 patients included in the study were hospitalized for AKI within up to two years of using low potency statins.
  • Patients using high potency statins who did not have chronic kidney disease were 34% more likely to be hospitalized with AKI in the first 120 days of treatment, compared to those using low potency statins. The rate of hospitalization for AKI did not significantly increase for patients with chronic kidney disease.
  • Patients and physicians need to carefully consider the risks and benefits of high dose statin therapy.
  • CNODES has the ability to analyze a large amount of anonymous patient data to reliably address questions about drug safety and effectiveness. The results of this study are consistent with previous research.
Implications
  • Patients may be exposed to unnecessary risk of kidney damage by taking high dose statins. Statin choice needs to be a decision between physician and patient, taking medical history and other factors into account.
Key message
  • Patients using high potency statins to lower their cholesterol levels have an increased risk of acute kidney injury (AKI), compared to those using low potency statins.

Manuscripts

Dormuth CR, Hemmelgarn BR, Paterson JM, James MT, Teare GF, Raymond CB, Lafrance JP, Levy A, Garg AX, Ernst P; Canadian Network for Observational Drug Effect Studies. Use of high potency statins and rates of admission for acute kidney injury: multicenter, retrospective observational analysis of administrative databases. BMJ. 2013 Mar 18;346:f880.

Presentations

Project Team

Project Lead
Colin R. Dormuth ScD
Methods Lead
Robert W. Platt PhD
Site Investigator
Gary Teare DVM, MSc, PhD
Saskatchewan
Site Investigator
Jacques LeLorier MD, MSc, FRCPC, FISPE
Quebec
Site Investigator
Michael Paterson MSc
Ontario
Site Investigator
Amit Garg MD, PhD
Ontario
Site Investigator
Charmaine Cooke
Atlantic
Site Investigator
Adrian Levy PhD
Atlantic
Site Investigator
Pierre Ernst MD, MSc, FRCPC
CPRD
Site Investigator
Colin R. Dormuth ScD
British Columbia
Site Investigator
Brenda Hemmelgarn MD, PhD, FRCPC
Alberta
Site Investigator
Matthew James MD, PhD
Alberta
Analyst
Hacene Nedjar
Quebec
Analyst
Jianguo (James) Zhang MSc
Alberta
Analyst
Fangyun Wu MSc
Ontario
Analyst
Upal Nath
Atlantic
Analyst
Dan Chateau PhD
Manitoba
Analyst
Richard Morrow Ma, PhD Candidate
British Columbia
Analyst
Nedeene Hudema
Saskatchewan
Collaborator
David Blackburn
Saskatchewan
Collaborator
Alomgir Hossain
Saskatchewan
Collaborator
Wenbin Li
Saskatchewan
Collaborator
Elham Rahme PhD
Quebec
Collaborator
Hala Tamim PhD
Atlantic
Collaborator
Lauren Bresee PhD
Alberta